| NPI | 1871900449 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: IL 051.296965) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MO 2013042272) |
| Enumeration Date | 2014-07-16 |
| Last Update Date | 2020-11-17 |