| NPI | 1902400070 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: IA 20250) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: IL 051290891) |
| Enumeration Date | 2020-11-29 |
| Last Update Date | 2021-07-31 |