| NPI | 1801913611 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MO 029042) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: IL 051.030456) |
| Enumeration Date | 2007-03-25 |
| Last Update Date | 2007-07-08 |