| NPI | 1558340711 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1835G0303X Pharmacist, Geriatric (Licence: FL PS63633) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: IL 051-287659) |
| Enumeration Date | 2006-01-15 |
| Last Update Date | 2022-12-20 |