| NPI | 1568179885 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: WA 61340130) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: SC 43443) |
| Enumeration Date | 2022-11-07 |
| Last Update Date | 2022-11-07 |