| NPI | 1548851785 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IN 71010783A) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IN 71010783A) |
| Enumeration Date | 2021-01-31 |
| Last Update Date | 2025-09-09 |