| NPI | 1730565003 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: IL 051034225) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: KY 008653) |
| Enumeration Date | 2015-08-10 |
| Last Update Date | 2015-08-10 |