| NPI | 1649630112 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: AR PD16146) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MS E-08400) |
| 183500000X Pharmacist (Licence: WA PH60587738) | |
| Enumeration Date | 2016-02-26 |
| Last Update Date | 2023-12-05 |