| NPI | 1720357932 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: CO 15275) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: IL 051.029322) |
| Enumeration Date | 2011-12-16 |
| Last Update Date | 2011-12-16 |