| NPI | 1124258058 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MO 2009020986) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: IL 051.294668) |
| Enumeration Date | 2009-07-27 |
| Last Update Date | 2015-09-01 |