| NPI | 1972802486 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: DE A1-0003835) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: PA RP443307) |
| 183500000X Pharmacist (Licence: MD 20070) | |
| Enumeration Date | 2011-03-23 |
| Last Update Date | 2011-03-23 |