| NPI | 1881091676 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: WA PH60510717) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: CA RPH87512) |
| Enumeration Date | 2014-11-24 |
| Last Update Date | 2026-05-13 |