| NPI | 1578284352 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: WA PHRM.PH.61325219) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: WA IR60871790) |
| Enumeration Date | 2022-09-08 |
| Last Update Date | 2022-09-08 |