| NPI | 1457986259 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: IN 71009973A) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IN 28199259A) |
| 363L00000X Nurse Practitioner (Licence: IN 71009973A) | |
| Enumeration Date | 2020-03-12 |
| Last Update Date | 2023-03-17 |