| NPI | 1942585377 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: CO 20060) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: TN 0000029732) |
| 183500000X Pharmacist (Licence: IL 051033921) | |
| Enumeration Date | 2011-10-17 |
| Last Update Date | 2017-02-14 |