| NPI | 1396349684 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 333600000X Pharmacy (Licence: AZ S024148) |
| Additional Taxonomies | 333600000X Pharmacy (Licence: IL 051303584) |
| Enumeration Date | 2020-11-26 |
| Last Update Date | 2022-04-26 |