| NPI | 1427626324 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: WA PH61177708) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: ID P9559) |
| Enumeration Date | 2021-06-16 |
| Last Update Date | 2021-09-28 |