| 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 | 2025-05-20 |