| NPI | 1285198150 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IN 71008859A) |
| Additional Taxonomies | 163WG0000X Registered Nurse, General Practice (Licence: IN 28200911A) |
| Enumeration Date | 2019-01-25 |
| Last Update Date | 2025-11-18 |