| NPI | 1881972628 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MD 18792) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: DE A1-0002694) |
| Enumeration Date | 2011-07-27 |
| Last Update Date | 2011-07-27 |