| NPI | 1104120229 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: IL 051294719) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: WA PH60101467) |
| Enumeration Date | 2011-01-04 |
| Last Update Date | 2013-12-02 |