| NPI | 1235947169 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IN 71016227A) |
| Additional Taxonomies | 163WE0003X Registered Nurse, Emergency (Licence: IN 28265469A) |
| Enumeration Date | 2024-12-23 |
| Last Update Date | 2025-05-28 |