| NPI | 1053768051 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: IN 71012724A) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: IL 041374538) |
| 363LF0000X Nurse Practitioner Family (Licence: IN 28274402A) | |
| 363LF0000X Nurse Practitioner Family (Licence: IL 209014299) | |
| Enumeration Date | 2016-05-19 |
| Last Update Date | 2023-10-12 |