| NPI | 1366043945 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: IL 051.297383) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MO 2012028249) |
| Enumeration Date | 2020-11-02 |
| Last Update Date | 2026-02-04 |