| NPI | 1407579444 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: TX 73922) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: IL 051305096) |
| Enumeration Date | 2022-09-23 |
| Last Update Date | 2024-07-07 |