| NPI | 1225314925 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MO 2010042622) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: IL 051.292653) |
| 183500000X Pharmacist (Licence: KS 1-14942) | |
| Enumeration Date | 2011-10-25 |
| Last Update Date | 2011-10-25 |