| NPI | 1366840167 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: IL 051.300022) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: CA 72074) |
| Enumeration Date | 2014-12-09 |
| Last Update Date | 2019-03-01 |