| NPI | 1912281577 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: DE A1-0004059) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: PA RP444714) |
| 183500000X Pharmacist (Licence: MD 19889) | |
| Enumeration Date | 2011-09-30 |
| Last Update Date | 2022-07-21 |