| NPI | 1548552144 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1835P0018X Pharmacist Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist (Licence: OR RPH-0011040) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: OR RPH-0011040) |
| 183500000X Pharmacist (Licence: WA PH00067644) | |
| Enumeration Date | 2011-05-15 |
| Last Update Date | 2017-02-22 |