| NPI | 1962816306 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: PA RP441561) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: IL 051.293206) |
| 183500000X Pharmacist (Licence: KY 015239) | |
| Enumeration Date | 2014-06-13 |
| Last Update Date | 2014-06-13 |