NPI | 1346996295 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: IN 28251946A) |
Additional Taxonomies | 163WM0705X Registered Nurse, Medical-Surgical (Licence: IN 28251946A) |
Enumeration Date | 2022-03-01 |
Last Update Date | 2022-08-24 |