| NPI | 1023726106 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IN 71013375A) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IN 71013375A) |
| 163WC0200X Registered Nurse, Critical Care Medicine (Licence: IN 28225726A) | |
| Enumeration Date | 2022-11-08 |
| Last Update Date | 2025-12-15 |