| NPI | 1992088256 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: DE A10002144) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: PA RP034808L) |
| 183500000X Pharmacist (Licence: CA RPH41992) | |
| Enumeration Date | 2011-09-23 |
| Last Update Date | 2011-09-23 |