| NPI | 1356640411 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: DE a1-0001741) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MD 09246) |
| Enumeration Date | 2011-03-15 |
| Last Update Date | 2011-03-15 |