| NPI | 1346517349 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: IA 17133) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: IL 051-037096) |
| Enumeration Date | 2011-11-19 |
| Last Update Date | 2019-04-23 |