| NPI | 1629671813 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: OR 18210) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: IL 051301445) |
| Enumeration Date | 2020-11-19 |
| Last Update Date | 2023-03-07 |