| NPI | 1336144625 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MO 040586) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: IL 051039674) |
| 1835P1200X Pharmacist, Pharmacotherapy (Licence: MO 040586) | |
| 1835P1200X Pharmacist, Pharmacotherapy (Licence: IL 051039674) | |
| 1835P1300X Pharmacist, Psychiatric (Licence: MO 040586) | |
| 1835P1300X Pharmacist, Psychiatric (Licence: IL 051039674) | |
| Enumeration Date | 2005-06-14 |
| Last Update Date | 2007-07-09 |