| NPI | 1447858477 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: WI 17789-40) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: IL 051.298441) |
| Enumeration Date | 2020-10-12 |
| Last Update Date | 2020-10-12 |