| NPI | 1992054118 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: DE A1-0002711) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: PA RP033306L) |
| Enumeration Date | 2012-09-04 |
| Last Update Date | 2012-09-04 |