| NPI | 1528772183 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IN 71016876B) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IN 28297994A) |
| 363LF0000X Nurse Practitioner, Family (Licence: MI 4704368010) | |
| 363LF0000X Nurse Practitioner, Family (Licence: IN 71016876A) | |
| 163W00000X Registered Nurse (Licence: MI 4704368010) | |
| Enumeration Date | 2023-01-09 |
| Last Update Date | 2025-10-14 |