| NPI | 1174936157 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: DE a10004521) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MD 21880) |
| Enumeration Date | 2014-06-06 |
| Last Update Date | 2014-06-06 |