| NPI | 1528814480 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: IN 71015364A) |
| Additional Taxonomies | 163WC0200X Registered Nurse, Critical Care Medicine (Licence: IN 28239739C) |
| 363L00000X Nurse Practitioner (Licence: IN 71015364A) | |
| Enumeration Date | 2024-04-30 |
| Last Update Date | 2024-12-05 |