| NPI | 1710217120 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 183500000X Pharmacist (Licence: WA PH00069746) |
| Enumeration Date | 2010-01-06 |
| Last Update Date | 2018-07-05 |