| NPI | 1215210794 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: IL 051294514) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MO 2010027767) |
| Enumeration Date | 2011-09-21 |
| Last Update Date | 2020-08-24 |