| NPI | 1649582875 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: WA PH00042218) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: SC 8057) |
| 183500000X Pharmacist (Licence: FL PS27637) | |
| Enumeration Date | 2010-07-02 |
| Last Update Date | 2010-07-02 |