| NPI | 1497893812 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835P1200X Pharmacist, Pharmacotherapy (Licence: WA PH00039712) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: WA PH00039712) |
| Enumeration Date | 2007-02-01 |
| Last Update Date | 2014-07-11 |