| NPI | 1669587721 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: DE A1-0003542) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: KS 12805) |
| 183500000X Pharmacist (Licence: MD 17947) | |
| Enumeration Date | 2006-08-20 |
| Last Update Date | 2007-07-08 |