| NPI | 1578934402 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LN0000X Nurse Practitioner, Neonatal (Licence: IN 71005880A) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IN 71005880A) |
| Enumeration Date | 2015-10-19 |
| Last Update Date | 2024-03-27 |