| NPI | 1073869053 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MO 042847) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: IL 036006) |
| Enumeration Date | 2012-07-27 |
| Last Update Date | 2012-07-27 |