| NPI | 1144669664 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NV 17838) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: IL 051.031263) |
| Enumeration Date | 2013-06-18 |
| Last Update Date | 2013-06-18 |