| NPI | 1104107390 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MO 2001024845) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: IL 051.293992) |
| Enumeration Date | 2011-09-01 |
| Last Update Date | 2022-12-17 |