NPI | 1477218899 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IN 71012085A) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: IN 28173287A) |
Enumeration Date | 2021-11-01 |
Last Update Date | 2022-01-11 |