| NPI | 1538103817 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: WA PH00019484) |
| Additional Taxonomies | 1835P1200X Pharmacist, Pharmacotherapy (Licence: WA PH00019484) |
| Enumeration Date | 2006-06-16 |
| Last Update Date | 2022-08-11 |