| NPI | 1497733323 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MT 46983) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: WA p43995) |
| Enumeration Date | 2005-12-30 |
| Last Update Date | 2023-01-06 |