| NPI | 1578819231 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: OR RPH0011338) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: AZ S013067) |
| 183500000X Pharmacist (Licence: MT 5479) | |
| 183500000X Pharmacist (Licence: WA PH60013276) | |
| 183500000X Pharmacist (Licence: NE 13511) | |
| Enumeration Date | 2012-07-31 |
| Last Update Date | 2012-10-17 |