| NPI | 1578182382 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: DE A1-0005114) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MD 21606) |
| Enumeration Date | 2020-04-11 |
| Last Update Date | 2022-08-24 |