NPI | 1669621066 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: IN 71002752A) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: IN 28150342) |
363L00000X Nurse Practitioner (Licence: IN 71002752A) | |
Enumeration Date | 2008-09-10 |
Last Update Date | 2023-08-02 |