| NPI | 1982902482 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: DE A1-0001985) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MD 09900) |
| 183500000X Pharmacist (Licence: VA 0202006627) | |
| Enumeration Date | 2011-03-08 |
| Last Update Date | 2011-03-08 |