| NPI | 1841696861 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: WA PH60168022) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: CA 70534) |
| Enumeration Date | 2014-11-19 |
| Last Update Date | 2014-11-19 |