| NPI | 1790202067 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MI 5302042580) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: IL 051.299394) |
| 183500000X Pharmacist (Licence: FL PS55725) | |
| Enumeration Date | 2017-08-27 |
| Last Update Date | 2017-08-27 |