| NPI | 1821366279 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MS P11723) |
| Additional Taxonomies | 251F00000X Home Infusion |
| 261QI0500X Clinic/Center, Infusion Therapy | |
| Enumeration Date | 2011-12-13 |
| Last Update Date | 2025-06-27 |