NPI | 1437406618 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IN 71001453A) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IN 28135849A) |
Enumeration Date | 2012-08-07 |
Last Update Date | 2018-03-17 |