| NPI | 1326824699 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IN 71015891A) |
| Additional Taxonomies | 163WC0200X Registered Nurse, Critical Care Medicine (Licence: IN 28258867A) |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: IN 28258867A) | |
| Enumeration Date | 2023-09-04 |
| Last Update Date | 2024-10-18 |