| NPI | 1548568835 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: WA ph00020358) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: CA 43280) |
| Enumeration Date | 2011-03-10 |
| Last Update Date | 2011-03-10 |