| NPI | 1881858843 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: WA PH60018976) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: WA PH60231719) |
| Enumeration Date | 2008-07-17 |
| Last Update Date | 2022-01-05 |