| NPI | 1568736932 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: VA 0202208565) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: IL 051294649) |
| Enumeration Date | 2012-03-02 |
| Last Update Date | 2012-12-17 |