| NPI | 1417514704 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: DE A1-0005026) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: PA RP448308) |
| Enumeration Date | 2019-05-22 |
| Last Update Date | 2019-05-22 |