| NPI | 1821359472 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: WA PH00018235) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: OR 8151) |
| 183500000X Pharmacist (Licence: AZ 8080) | |
| Enumeration Date | 2012-05-30 |
| Last Update Date | 2012-05-30 |