| NPI | 1912580465 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MO 2016007951) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: IL 051297649) |
| Enumeration Date | 2021-05-03 |
| Last Update Date | 2023-09-06 |