| NPI | 1598034282 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MO 2011021861) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: IL 051.295063) |
| Enumeration Date | 2011-12-24 |
| Last Update Date | 2017-01-04 |