| NPI | 1790971810 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: IL 051294184) |
| Additional Taxonomies | 183700000X Pharmacy Technician (Licence: IL 49149269) |
| Enumeration Date | 2007-09-21 |
| Last Update Date | 2019-08-15 |