| NPI | 1881988731 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: TX 52675) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: IL 051.293595) |
| Enumeration Date | 2011-06-07 |
| Last Update Date | 2013-01-20 |