| NPI | 1952887101 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MO 2014027820) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: IL 051.299322) |
| Enumeration Date | 2018-07-11 |
| Last Update Date | 2018-07-11 |