| NPI | 1578931895 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1835P0018X Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist (Licence: OR 0014951) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: OR RPH-0014951) |
| 183500000X Pharmacist (Licence: WA PH60620587) | |
| Enumeration Date | 2015-09-02 |
| Last Update Date | 2020-11-20 |