| NPI | 1871993915 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: WA PH60094346) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: OR RPH-0009110) |
| Enumeration Date | 2014-08-26 |
| Last Update Date | 2014-08-26 |