| NPI | 1417144080 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: WA PH00041212) |
| Additional Taxonomies | 1835C0206X (Licence: WA PH00041212) |
| 1835E0208X (Licence: WA PH00041212) | |
| 1835C0205X Pharmacist Critical Care (Licence: WA PH00041212) | |
| 1835G0303X Pharmacist Geriatric (Licence: WA PH00041212) | |
| 1835P1300X Pharmacist Psychiatric (Licence: WA PH00041212) | |
| 1835P2201X Pharmacist Ambulatory Care (Licence: WA PH00041212) | |
| 1835P0200X Pharmacist Pediatrics (Licence: WA PH00041212) | |
| 1835P1200X Pharmacist Pharmacotherapy (Licence: WA PH00041212) | |
| Enumeration Date | 2007-09-27 |
| Last Update Date | 2024-02-29 |