| NPI | 1629021001 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1835P0018X Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist (Licence: WA PH00063797) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: WA PH00063797) |
| 183500000X Pharmacist (Licence: AZ 14793) | |
| 1835P1200X Pharmacist, Pharmacotherapy (Licence: AZ 14793) | |
| 1835P1200X Pharmacist, Pharmacotherapy (Licence: WA PH00063797) | |
| 1835P1300X Pharmacist, Psychiatric (Licence: WA PH00063797) | |
| 1835P1300X Pharmacist, Psychiatric (Licence: AZ 14793) | |
| 1835P0018X Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist (Licence: AZ 14793) | |
| Enumeration Date | 2006-05-18 |
| Last Update Date | 2013-10-03 |