| NPI | 1235174004 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835P1200X Pharmacist, Pharmacotherapy (Licence: OR RPH-0013059) |
| Additional Taxonomies | 1835P1200X Pharmacist, Pharmacotherapy (Licence: WA PH00016183) |
| Enumeration Date | 2006-06-17 |
| Last Update Date | 2026-01-15 |