| NPI | 1679695035 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1835P1200X Pharmacist, Pharmacotherapy (Licence: AZ 9155) |
| Additional Taxonomies | 1835P1200X Pharmacist, Pharmacotherapy (Licence: IL 0051-036224) |
| 1835P1300X Pharmacist, Psychiatric (Licence: AZ 9155) | |
| 1835P1300X Pharmacist, Psychiatric (Licence: IL 0051-036224) | |
| Enumeration Date | 2007-04-05 |
| Last Update Date | 2007-08-30 |