| NPI | 1811227747 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: WA ph00055269) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: AK 1863) |
| Enumeration Date | 2009-12-24 |
| Last Update Date | 2009-12-24 |