| NPI | 1063874543 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MD 17372) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: DE a1-0003480) |
| Enumeration Date | 2016-03-24 |
| Last Update Date | 2016-03-24 |