| NPI | 1821355397 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: WA IR60151565) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: ID E14846) |
| Enumeration Date | 2012-04-20 |
| Last Update Date | 2012-04-20 |