| NPI | 1619123981 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835P0018X Pharmacist Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist (Licence: WA PH60017365) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: OR RPH-0011308) |
| Enumeration Date | 2008-08-18 |
| Last Update Date | 2018-07-03 |