| NPI | 1447345632 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: IN 71000193A) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IN 71000193) |
| Enumeration Date | 2006-10-04 |
| Last Update Date | 2022-08-10 |