| NPI | 1710265657 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: IA 17508) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: IL 051.288713) |
| Enumeration Date | 2011-07-26 |
| Last Update Date | 2014-06-20 |