| NPI | 1720899883 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IN 71016366A) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IN 28248443A) |
| Enumeration Date | 2025-01-17 |
| Last Update Date | 2025-05-05 |