| NPI | 1770046815 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IN 71010006A) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TN 161413) |
| 163W00000X Registered Nurse (Licence: IN 28258554A) | |
| 363LF0000X Nurse Practitioner, Family (Licence: TN 25636) | |
| Enumeration Date | 2019-04-06 |
| Last Update Date | 2020-12-22 |