| NPI | 1700169729 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835P0018X Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist (Licence: WA PH60935585) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MO 2010026508) |
| Enumeration Date | 2011-09-26 |
| Last Update Date | 2020-01-10 |