| NPI | 1497968838 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: WA ph00011739) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: OR rph0010712) |
| Enumeration Date | 2007-05-08 |
| Last Update Date | 2020-02-11 |