| NPI | 1447685284 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: WA PH60386509) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MT PH17944) |
| Enumeration Date | 2013-09-12 |
| Last Update Date | 2018-12-13 |