| NPI | 1740412782 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: OR RPH-0015759) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: WA PH60015291) |
| Enumeration Date | 2009-08-09 |
| Last Update Date | 2017-03-20 |