| NPI | 1629356050 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: CA 69936) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: IL 051295163) |
| Enumeration Date | 2011-08-02 |
| Last Update Date | 2022-07-21 |