| NPI | 1720383896 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835P0018X Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist (Licence: WA PH60827712) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MT 6317) |
| 183500000X Pharmacist (Licence: AK 1958) | |
| 183500000X Pharmacist (Licence: WA PH60827712) | |
| Enumeration Date | 2011-01-20 |
| Last Update Date | 2022-08-11 |