| NPI | 1861523573 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: AZ 7975) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: IL 051027819) |
| Enumeration Date | 2007-03-07 |
| Last Update Date | 2012-12-31 |