| NPI | 1588958763 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MO 2010028705) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: IL 051292115) |
| Enumeration Date | 2011-06-05 |
| Last Update Date | 2011-09-12 |