| NPI | 1528109535 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: FL PS 23199) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: IL 051.031443) |
| Enumeration Date | 2007-02-11 |
| Last Update Date | 2007-07-08 |