| NPI | 1649438300 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: DE A1-0003653) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: PA RP448885) |
| Enumeration Date | 2008-05-29 |
| Last Update Date | 2023-04-21 |