| NPI | 1164258919 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: DE A1-0016066) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: PA RP458653) |
| Enumeration Date | 2024-09-10 |
| Last Update Date | 2024-09-10 |