| NPI | 1740521293 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: TX 40641) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: IL 293212) |
| 183500000X Pharmacist (Licence: OR 0011695) | |
| Enumeration Date | 2013-03-08 |
| Last Update Date | 2013-03-08 |