| NPI | 1215397591 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: FL PS31255) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: IL 051296679) |
| Enumeration Date | 2016-03-01 |
| Last Update Date | 2016-03-01 |