| NPI | 1144885161 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: WA PH60951327) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MS E-13943) |
| Enumeration Date | 2019-05-06 |
| Last Update Date | 2019-11-17 |