| NPI | 1457541401 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: WA PH00069467) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NE 12693) |
| Enumeration Date | 2007-07-26 |
| Last Update Date | 2007-07-26 |