| NPI | 1609413616 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MO 2018032019) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: IL 051301897) |
| Enumeration Date | 2019-12-09 |
| Last Update Date | 2019-12-09 |