| NPI | 1790339943 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IN 71009617A) |
| Additional Taxonomies | 163WC0200X Registered Nurse, Critical Care Medicine (Licence: IN 28210202A) |
| Enumeration Date | 2019-07-26 |
| Last Update Date | 2022-05-25 |