| NPI | 1639845845 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: IL 051.298321) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: WI 15992-40) |
| Enumeration Date | 2021-08-18 |
| Last Update Date | 2021-08-18 |