| NPI | 1508856584 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1835P0018X Pharmacist Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist (Licence: WA PH00011227) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: WA PH00011227) |
| Enumeration Date | 2005-10-21 |
| Last Update Date | 2012-05-14 |