| NPI | 1013201276 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: IL 051.033683) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MN 116292) |
| 183500000X Pharmacist (Licence: MO 2001031809) | |
| Enumeration Date | 2011-06-06 |
| Last Update Date | 2011-06-06 |