| NPI | 1346515004 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: OR 0006837) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: CA PM035823) |
| 183500000X Pharmacist (Licence: WA PH60444165) | |
| Enumeration Date | 2012-03-14 |
| Last Update Date | 2015-09-30 |