| NPI | 1215323472 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MO 2001030151) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: IL 051.288733) |
| 183500000X Pharmacist (Licence: AR PD12980) | |
| Enumeration Date | 2015-04-14 |
| Last Update Date | 2015-04-14 |