| NPI | 1679108997 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: WI 19528-40) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: IL 051.301812) |
| Enumeration Date | 2020-03-06 |
| Last Update Date | 2020-07-07 |