| NPI | 1891071841 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: DE a10002247) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: FL ps40906) |
| 183500000X Pharmacist (Licence: PA rp038715r) | |
| Enumeration Date | 2011-10-21 |
| Last Update Date | 2011-10-21 |