| NPI | 1780534578 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: WA PHRM.PH.61682548) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: WI 23014-40) |
| Enumeration Date | 2026-01-30 |
| Last Update Date | 2026-01-30 |