| NPI | 1851666770 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: WA PH00009053) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: AZ S018416) |
| Enumeration Date | 2012-03-09 |
| Last Update Date | 2012-03-09 |