| NPI | 1932516051 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: WA PH00021177) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NM RP00004371) |
| Enumeration Date | 2014-07-21 |
| Last Update Date | 2014-07-21 |