| NPI | 1164025763 |
|---|---|
| Former Name | ALEX YELISAV |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: RI 04249) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MA 26451) |
| Enumeration Date | 2020-11-17 |
| Last Update Date | 2020-11-17 |