| NPI | 1265826226 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 364SC1501X Clinical Nurse Specialist, Community Health/Public Health (Licence: IN 71005395A) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IN 71005395A) |
| Enumeration Date | 2015-03-26 |
| Last Update Date | 2015-07-30 |