| NPI | 1205004439 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: TX 57421) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: DE A1-0003134) |
| 183500000X Pharmacist (Licence: PA RP044959L) | |
| Enumeration Date | 2008-02-11 |
| Last Update Date | 2021-11-08 |