| NPI | 1912181439 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: DE A1-0003226) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MD 17074) |
| Enumeration Date | 2007-12-19 |
| Last Update Date | 2007-12-19 |