| NPI | 1508056912 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MO 2004003291) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: IL 051-287044) |
| Enumeration Date | 2007-07-31 |
| Last Update Date | 2007-07-31 |