| NPI | 1972882108 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1835P0018X Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist (Licence: WA PH60213388) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: WA PH 60213388) |
| Enumeration Date | 2011-08-05 |
| Last Update Date | 2018-08-03 |