| NPI | 1881691871 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: WA PH00046151) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: PA RP038909L) |
| Enumeration Date | 2005-07-05 |
| Last Update Date | 2009-01-15 |