| NPI | 1902250145 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: OR RPH-0016267) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: WA PH60768137) |
| Enumeration Date | 2016-04-13 |
| Last Update Date | 2019-09-06 |