| NPI | 1396020822 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: IA 14501) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: IL 051029272) |
| Enumeration Date | 2011-10-16 |
| Last Update Date | 2011-10-16 |