| NPI | 1083998892 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: PA RP030231L) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: DE A10003260) |
| Enumeration Date | 2011-09-29 |
| Last Update Date | 2011-09-29 |