| NPI | 1295027357 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: AK 1990) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: WA PH60148249) |
| 183500000X Pharmacist (Licence: CA RPH 31838) | |
| 183500000X Pharmacist (Licence: OR 6495) | |
| Enumeration Date | 2011-05-09 |
| Last Update Date | 2011-05-09 |