| NPI | 1063175842 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: IL 051300907) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: WI 19222-40) |
| 183500000X Pharmacist (Licence: WI 26027447A) | |
| 183500000X Pharmacist (Licence: TX 65475) | |
| Enumeration Date | 2021-10-18 |
| Last Update Date | 2021-10-18 |