| NPI | 1780170092 |
|---|---|
| Former Name | SUPALKUMAR PATEL |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NJ 26NJ00964200) |
| Additional Taxonomies | 163WM0705X Registered Nurse, Medical-Surgical (Licence: NJ 26NR16668400) |
| Enumeration Date | 2018-07-10 |
| Last Update Date | 2021-07-27 |