| NPI | 1457877243 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: KY 019319) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: IL 051.300878) |
| 183500000X Pharmacist (Licence: FL PS59709) | |
| 183500000X Pharmacist (Licence: MD 25696) | |
| Enumeration Date | 2017-08-14 |
| Last Update Date | 2019-12-11 |