| NPI | 1154411593 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: DE A1-0001952) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: PA rp032463l) |
| 183500000X Pharmacist (Licence: MD 10249) | |
| Enumeration Date | 2006-10-14 |
| Last Update Date | 2024-02-14 |