| NPI | 1942873302 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: IL 051295515) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: TX 66527) |
| 183500000X Pharmacist (Licence: IA 22149) | |
| Enumeration Date | 2021-07-22 |
| Last Update Date | 2021-07-22 |