| NPI | 1013400944 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: DE A10005153) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MD 25430) |
| Enumeration Date | 2018-06-14 |
| Last Update Date | 2018-06-14 |