| NPI | 1619244290 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: WI 14194-040) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: IL 051.292884) |
| Enumeration Date | 2011-11-25 |
| Last Update Date | 2011-11-25 |