| NPI | 1275081721 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: WA PH 60501199) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: OR RPH-0014441) |
| Enumeration Date | 2016-09-13 |
| Last Update Date | 2016-09-13 |