| NPI | 1407453129 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: WA PH61424827) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: IL 051303342) |
| Enumeration Date | 2020-10-06 |
| Last Update Date | 2023-06-27 |