| NPI | 1114505757 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC KHAN-YVB7H) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NC F02211095) |
| Enumeration Date | 2021-04-01 |
| Last Update Date | 2021-08-18 |