| NPI | 1689107153 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835P0018X Pharmacist Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist (Licence: WA PH00040680) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: WA PH00040680) |
| Enumeration Date | 2017-04-11 |
| Last Update Date | 2018-06-21 |