| NPI | 1407865850 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: IL 051040228) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MI 5302030133) |
| Enumeration Date | 2006-08-05 |
| Last Update Date | 2007-07-08 |