NPI | 1336878628 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IN 71012621A) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: IN 28251265A) |
363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: IN 71012621A) | |
Enumeration Date | 2022-06-10 |
Last Update Date | 2022-06-20 |