| NPI | 1922527902 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: OR RPH-0017700) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: WA PH60758252) |
| Enumeration Date | 2017-09-12 |
| Last Update Date | 2025-12-03 |