| NPI | 1649416298 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MT 5346) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: WA PH00068296) |
| 183500000X Pharmacist (Licence: ID P7407) | |
| Enumeration Date | 2009-01-04 |
| Last Update Date | 2022-07-21 |