| NPI | 1629313630 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: IL 051295840) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: KY 019849) |
| Enumeration Date | 2012-12-02 |
| Last Update Date | 2020-11-24 |