| NPI | 1295035566 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: WA PH60359422) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: AK 1983) |
| Enumeration Date | 2010-11-02 |
| Last Update Date | 2018-11-30 |