| NPI | 1982259172 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: WI 22073) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: WA PH60943591) |
| Enumeration Date | 2019-08-05 |
| Last Update Date | 2024-06-21 |