NPI | 1235993478 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IN 71015044A) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IN 28231543A) |
Enumeration Date | 2024-02-08 |
Last Update Date | 2024-05-09 |