| NPI | 1114324548 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: DE A1-0004585) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MD 21840) |
| Enumeration Date | 2014-12-01 |
| Last Update Date | 2014-12-01 |