NPI | 1245944198 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IN 71014733A) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IN F0220799) |
Enumeration Date | 2023-01-05 |
Last Update Date | 2023-12-12 |