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Individual
EDGAR AUF DEM GRABEN
Active
Individual
EDGAR AUF DEM GRABEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Taxonomy
Speciality
Code
Description
License number
State
1835G0303X
Geriatric Pharmacist
Primary
054-035924
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
054-035924
ILLINOIS DEPARTMENT OF FINANCIAL AND PROFESSIONAL REGULATION
IL
Enumeration date
04/17/2019
Last updated
11/27/2023
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