| NPI | 1821372111 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: WA PH60713165) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: CA RPH64663) |
| Enumeration Date | 2011-10-05 |
| Last Update Date | 2021-08-05 |