| NPI | 1215778253 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IN F06240043) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IN 71015379A) |
| Enumeration Date | 2024-06-04 |
| Last Update Date | 2025-09-09 |