| NPI | 1437183639 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IN 71001822A) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IN 2004003813) |
| Enumeration Date | 2006-07-11 |
| Last Update Date | 2022-02-02 |