| NPI | 1972964963 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: SC 39501) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: IL 051036205) |
| 183500000X Pharmacist (Licence: VI 320) | |
| Enumeration Date | 2016-03-17 |
| Last Update Date | 2016-03-17 |