| NPI | 1851611198 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: WA ph60188356) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: CA 63690) |
| Enumeration Date | 2010-06-09 |
| Last Update Date | 2012-06-28 |