| NPI | 1245465467 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MO 2006024046) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: IL 051287298) |
| Enumeration Date | 2009-05-18 |
| Last Update Date | 2016-12-21 |