NPI | 1194093807 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IN 71003875A) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IN 28138800A) |
Enumeration Date | 2011-12-08 |
Last Update Date | 2023-11-03 |