| NPI | 1609102409 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NC 17061) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: IL 051289263) |
| Enumeration Date | 2009-10-29 |
| Last Update Date | 2012-02-07 |