| NPI | 1275217382 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IN 71014044A) |
| Additional Taxonomies | 163WC0200X Registered Nurse, Critical Care Medicine (Licence: IN 28219153A) |
| Enumeration Date | 2023-06-12 |
| Last Update Date | 2023-08-02 |