| NPI | 1215286752 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: WI 16879-40) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: IL 051296162) |
| Enumeration Date | 2012-08-30 |
| Last Update Date | 2012-09-01 |