| NPI | 1649870130 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NV 20540) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: IL 051.298926) |
| Enumeration Date | 2020-10-26 |
| Last Update Date | 2025-01-10 |