| NPI | 1679767206 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MT 3291) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: IL 51289371) |
| 1835P1200X Pharmacist Pharmacotherapy (Licence: MT 3291) | |
| 1835P1200X Pharmacist Pharmacotherapy (Licence: IL 51289371) | |
| Enumeration Date | 2007-08-28 |
| Last Update Date | 2007-08-28 |