| NPI | 1730728619 | 
|---|---|
| Former Name | JAMAL ATHARI | 
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: CT 9064)  | 
| Additional Taxonomies | 163WE0003X Registered Nurse, Emergency (Licence: CT 10.126810)  | 
| Enumeration Date | 2019-12-25 | 
| Last Update Date | 2020-08-04 |