| NPI | 1639562341 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: DE A1-0004616) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: DC PH100001599) |
| Enumeration Date | 2015-03-05 |
| Last Update Date | 2015-03-05 |