| NPI | 1992309298 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: WA PH61079615) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: WA 61089851) |
| Enumeration Date | 2020-11-27 |
| Last Update Date | 2024-04-23 |