| NPI | 1568035087 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: IL 051303510) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: TX 68610) |
| Enumeration Date | 2021-07-22 |
| Last Update Date | 2025-01-09 |