| NPI | 1376545285 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MO 2004020855) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: IL 051-289254) |
| Enumeration Date | 2005-08-10 |
| Last Update Date | 2007-07-08 |