| NPI | 1144897679 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: WA PH61086666) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: CA RPH75503) |
| Enumeration Date | 2021-06-04 |
| Last Update Date | 2021-06-04 |