| NPI | 1134913601 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: IN 28268952A) |
| Additional Taxonomies | 363LA2100X Nurse Practitioner, Acute Care (Licence: IN 71016620A) |
| Enumeration Date | 2025-04-08 |
| Last Update Date | 2025-08-05 |