| NPI | 1396466629 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835P0018X Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist (Licence: WA PH61602666) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MO 2022032713) |
| 183500000X Pharmacist (Licence: CA RPH92337) | |
| Enumeration Date | 2022-09-06 |
| Last Update Date | 2026-06-05 |