| NPI | 1962202176 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: IA 25256) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: IL 051.307630) |
| Enumeration Date | 2025-03-17 |
| Last Update Date | 2025-11-03 |