| NPI | 1013271501 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: WI 16629-40) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: IL 051036213) |
| Enumeration Date | 2012-06-28 |
| Last Update Date | 2012-06-28 |