| NPI | 1215289061 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: TX 42108) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: IL 051040855) |
| Enumeration Date | 2012-10-03 |
| Last Update Date | 2016-02-24 |