| NPI | 1184876633 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: CA 68509) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: WA PH00069476) |
| Enumeration Date | 2008-10-15 |
| Last Update Date | 2024-03-06 |