| NPI | 1598253577 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IN 71007932A) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: IN 71007932A) |
| 363LF0000X Nurse Practitioner, Family (Licence: IN 71007932A) | |
| Enumeration Date | 2018-04-25 |
| Last Update Date | 2020-06-09 |