NPI | 1689294357 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IN 28163222A) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IN 71009965A) |
Enumeration Date | 2020-04-22 |
Last Update Date | 2020-09-15 |