| NPI | 1700162567 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MO 2007023343) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: IL 051292647) |
| Enumeration Date | 2011-10-25 |
| Last Update Date | 2011-10-25 |