| NPI | 1376869669 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IN 71003256A) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: IN 71003256A) |
| Enumeration Date | 2010-04-13 |
| Last Update Date | 2023-10-10 |