| NPI | 1801239843 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: WI 16916-40) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: IL 051.295938) |
| Enumeration Date | 2013-04-09 |
| Last Update Date | 2019-11-13 |