| NPI | 1326540915 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: IL 051300659) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: WA PH60665385) |
| Enumeration Date | 2018-02-28 |
| Last Update Date | 2018-02-28 |