NPI | 1437625803 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IN 71008548A) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IN 28150165A) |
Enumeration Date | 2018-10-23 |
Last Update Date | 2019-07-22 |