| NPI | 1972978351 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: WI 13184-40) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: FL ps50298) |
| 183500000X Pharmacist (Licence: WA ph40565) | |
| Enumeration Date | 2015-12-10 |
| Last Update Date | 2015-12-10 |