| NPI | 1831365188 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 183500000X Pharmacist (Licence: AZ 11548)  | 
| Additional Taxonomies | 183500000X Pharmacist (Licence: IL 051.033905)  | 
| Enumeration Date | 2008-05-07 | 
| Last Update Date | 2008-05-07 |