| NPI | 1578939591 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IN 71012205A) |
| Additional Taxonomies | 163WE0003X Registered Nurse, Emergency (Licence: IN 28144204A) |
| 363LF0000X Nurse Practitioner, Family (Licence: IN 7101225A) | |
| Enumeration Date | 2015-08-13 |
| Last Update Date | 2022-04-06 |