| NPI | 1831588425 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MO 2014025398) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: IL 051298285) |
| Enumeration Date | 2015-01-20 |
| Last Update Date | 2015-01-20 |