| NPI | 1295454981 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: IN 71014474A) |
| Additional Taxonomies | 163WC0200X Registered Nurse, Critical Care Medicine (Licence: IN 28234023A) |
| Enumeration Date | 2022-08-25 |
| Last Update Date | 2023-10-17 |