| NPI | 1467825257 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IN 71005955A) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IN 71005955A) |
| 363LF0000X Nurse Practitioner, Family (Licence: IN 28181261A) | |
| Enumeration Date | 2015-11-03 |
| Last Update Date | 2022-06-17 |