| NPI | 1679986616 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: AZ S019379) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: IL 051.299425) |
| Enumeration Date | 2014-06-07 |
| Last Update Date | 2024-05-21 |