| NPI | 1083255988 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: TX 64774) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: IL 051.302613) |
| Enumeration Date | 2019-10-01 |
| Last Update Date | 2022-08-23 |