| NPI | 1174867543 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835P0018X Pharmacist Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist (Licence: IL 051.296029) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: IL 051.296029) |
| 1835P2201X Pharmacist Ambulatory Care (Licence: MA 24008) | |
| 183500000X Pharmacist (Licence: WI 16781-41) | |
| Enumeration Date | 2012-11-25 |
| Last Update Date | 2022-04-04 |