| NPI | 1740672724 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: WA PH60418716) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MA PH234821) |
| 183500000X Pharmacist (Licence: TX 54270) | |
| Enumeration Date | 2015-02-26 |
| Last Update Date | 2015-02-26 |