| NPI | 1073896155 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: DE A1-0003386) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: PA RP438642) |
| Enumeration Date | 2011-09-24 |
| Last Update Date | 2011-09-24 |