| NPI | 1649689605 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: IL 051030951) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: CA 31221) |
| 183500000X Pharmacist (Licence: MS T12417) | |
| Enumeration Date | 2014-08-04 |
| Last Update Date | 2014-08-04 |