| NPI | 1275015992 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: WA PH60866123) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: WI 17711-40) |
| 183500000X Pharmacist (Licence: IL 051300254) | |
| Enumeration Date | 2018-08-29 |
| Last Update Date | 2018-08-29 |