| NPI | 1790114403 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1835P0018X Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist (Licence: WA PH 00018500) |
| Enumeration Date | 2013-11-03 |
| Last Update Date | 2013-11-03 |