| NPI | 1437554003 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: AZ S020999) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: WA PH60484915) |
| Enumeration Date | 2014-10-24 |
| Last Update Date | 2015-05-12 |