| NPI | 1912269093 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1835P0018X Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist (Licence: WA PH 00009806) |
| Enumeration Date | 2012-06-13 |
| Last Update Date | 2012-06-13 |