| NPI | 1407143704 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: IL 051.289989) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MO 2017033617) |
| Enumeration Date | 2011-07-07 |
| Last Update Date | 2019-03-04 |