| NPI | 1124729074 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: DE A1-0004096) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: PA RP043158L) |
| Enumeration Date | 2023-03-16 |
| Last Update Date | 2023-03-16 |