| NPI | 1558258657 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NH 114610-23) |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: NH 114610-23) |
| Enumeration Date | 2025-06-20 |
| Last Update Date | 2025-09-26 |