| NPI | 1639734643 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: OR RPH-0017062) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: WA PH60928722) |
| Enumeration Date | 2019-05-06 |
| Last Update Date | 2019-05-06 |