| NPI | 1063023885 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: DE A1-0005326) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MD 27151) |
| Enumeration Date | 2020-08-14 |
| Last Update Date | 2022-08-31 |