NPI | 1669037560 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: IN 7107165A) |
Additional Taxonomies | 163WM0705X Registered Nurse, Medical-Surgical (Licence: IN 28298460A) |
163WE0003X Registered Nurse, Emergency (Licence: AZ RN188867) | |
363LA2200X Nurse Practitioner, Adult Health (Licence: IN 7107165A) | |
363LG0600X Nurse Practitioner, Gerontology (Licence: AZ 226021) | |
163WC0200X Registered Nurse, Critical Care Medicine (Licence: IN 28298460A) | |
363LG0600X Nurse Practitioner, Gerontology (Licence: IN 71017165A) | |
Enumeration Date | 2019-05-06 |
Last Update Date | 2025-10-01 |