| NPI | 1093936478 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: WA PH00041603) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: IL 51-27610) |
| 1835N0905X Pharmacist, Nuclear (Licence: WA PH00041603) | |
| 1835N0905X Pharmacist, Nuclear (Licence: IL 51-24610) | |
| Enumeration Date | 2007-05-01 |
| Last Update Date | 2007-07-08 |