| NPI | 1386333722 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: WA PH61441586) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: OR RPH-0019012) |
| Enumeration Date | 2023-05-02 |
| Last Update Date | 2023-07-07 |