| NPI | 1295876233 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835P1200X Pharmacist, Pharmacotherapy (Licence: MT 3321) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: WA PH 60191326) |
| Enumeration Date | 2007-02-11 |
| Last Update Date | 2012-09-27 |