| NPI | 1922287051 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: IL 051.288848) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: IA 19624) |
| Enumeration Date | 2007-10-25 |
| Last Update Date | 2007-10-25 |