| NPI | 1215293261 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: IL 051.039749) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: IA 18189) |
| Enumeration Date | 2012-04-04 |
| Last Update Date | 2012-04-04 |