| NPI | 1902350762 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: TX 68239) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: IL 051299711) |
| Enumeration Date | 2016-08-10 |
| Last Update Date | 2022-12-16 |