| NPI | 1750895314 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: WA PH60207468) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: GA RPH026204) |
| Enumeration Date | 2017-11-18 |
| Last Update Date | 2017-11-18 |