| NPI | 1821178674 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: OR rph0009721) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: WA ph00015560) |
| Enumeration Date | 2006-10-16 |
| Last Update Date | 2007-07-08 |