| NPI | 1417218967 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MD 22986) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: DE A1-0004882) |
| Enumeration Date | 2012-05-31 |
| Last Update Date | 2016-11-07 |