| NPI | 1982901971 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MD 11647) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: PA RP035785T) |
| 183500000X Pharmacist (Licence: DE A1-0002064) | |
| Enumeration Date | 2011-02-28 |
| Last Update Date | 2011-02-28 |