| NPI | 1194146944 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: CA 74080) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: IL 051.296895) |
| Enumeration Date | 2013-12-20 |
| Last Update Date | 2019-10-08 |