| NPI | 1295560217 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IN 71017831A) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IN 71017831B) |
| 163WG0000X Registered Nurse, General Practice (Licence: IN 28276081) | |
| Enumeration Date | 2024-09-09 |
| Last Update Date | 2026-05-18 |