| NPI | 1285273821 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MO 2019031421) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: IL 051.302655) |
| Enumeration Date | 2019-12-30 |
| Last Update Date | 2019-12-30 |