| NPI | 1588962195 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: DE a1-0003335) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: PA rp044270l) |
| Enumeration Date | 2011-03-05 |
| Last Update Date | 2011-03-05 |