| NPI | 1396012977 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: DE A1-00004225) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: PA RP446293) |
| Enumeration Date | 2011-11-25 |
| Last Update Date | 2011-11-25 |