| NPI | 1023303682 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183700000X Pharmacy Technician (Licence: IL 049.160038) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NY 087172) |
| Enumeration Date | 2011-06-12 |
| Last Update Date | 2011-06-12 |