| NPI | 1447513742 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: WA PH 00010742) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: HI PH-715) |
| Enumeration Date | 2012-06-21 |
| Last Update Date | 2012-06-21 |