| NPI | 1982986410 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MD 24379) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: DE a1-0003947) |
| Enumeration Date | 2011-09-11 |
| Last Update Date | 2016-09-07 |