NPI | 1801534144 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IN 71015172A) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TN 31235) |
363LP2300X Nurse Practitioner, Primary Care (Licence: TN 31235) | |
Enumeration Date | 2022-05-26 |
Last Update Date | 2024-04-15 |