| NPI | 1134407026 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IN 71003664A) |
| Additional Taxonomies | 364SC0200X Clinical Nurse Specialist, Critical Care Medicine (Licence: IN 28159266A) |
| Enumeration Date | 2011-07-27 |
| Last Update Date | 2023-11-27 |