| NPI | 1275275570 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: WA 61324948) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MO 2021033961) |
| Enumeration Date | 2022-04-08 |
| Last Update Date | 2023-03-20 |