| NPI | 1215687058 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IN 71012403A) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IN CS0365835) |
| Enumeration Date | 2022-03-25 |
| Last Update Date | 2025-02-10 |