NPI | 1649949561 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IN 71011956A) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IN 2021083835) |
Enumeration Date | 2021-09-13 |
Last Update Date | 2023-05-04 |