| NPI | 1528100633 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MO 028128) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: IL 051-29918) |
| Enumeration Date | 2007-02-13 |
| Last Update Date | 2007-07-08 |