| NPI | 1730590928 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: WA PH60390978) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: OR RPH-0013593) |
| 1835P0018X Pharmacist Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist (Licence: OR RPH-0013593) | |
| Enumeration Date | 2014-05-11 |
| Last Update Date | 2018-11-18 |