| NPI | 1215425418 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NJ 28RI03409700) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: IL 051292042) |
| Enumeration Date | 2018-04-24 |
| Last Update Date | 2018-04-24 |