| NPI | 1841666732 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: WA PH60490695) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: OR RPH-0014716) |
| Enumeration Date | 2015-08-14 |
| Last Update Date | 2015-08-14 |