| NPI | 1639170673 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NY 048043) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: IL 051-287284) |
| Enumeration Date | 2005-08-01 |
| Last Update Date | 2007-07-08 |