| NPI | 1053696153 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: IA 19323) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: IL 051288109) |
| Enumeration Date | 2011-10-20 |
| Last Update Date | 2013-08-08 |