| NPI | 1518185701 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: WA PH00020792) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: IL 51038313) |
| Enumeration Date | 2007-04-23 |
| Last Update Date | 2007-07-08 |