| NPI | 1386942993 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: FL 45976) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: DE A1-0004035) |
| Enumeration Date | 2011-03-06 |
| Last Update Date | 2013-07-27 |