| NPI | 1114205044 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835G0303X Pharmacist Geriatric (Licence: IA 15578) |
| Additional Taxonomies | 1835G0303X Pharmacist Geriatric (Licence: IL 051-032742) |
| Enumeration Date | 2011-07-26 |
| Last Update Date | 2011-07-26 |