| NPI | 1396524955 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IN 71015818A) |
| Additional Taxonomies | 163WM0705X Registered Nurse, Medical-Surgical (Licence: IN 28257002A) |
| Enumeration Date | 2023-09-25 |
| Last Update Date | 2025-04-02 |