| NPI | 1932834413 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: OR RPH-0018908) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: WA PH61648984) |
| Enumeration Date | 2022-07-19 |
| Last Update Date | 2025-07-31 |