| NPI | 1669734893 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1835P0018X Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist (Licence: WA PH60585566) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: WA PH60585566) |
| 183500000X Pharmacist (Licence: MO 2011026635) | |
| 183500000X Pharmacist (Licence: IL 051.294975) | |
| Enumeration Date | 2012-06-13 |
| Last Update Date | 2023-05-04 |