| NPI | 1831865054 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IN 71011631A) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IN 71011631A) |
| 207P00000X Emergency Medicine (Licence: IN 71011631A) | |
| Enumeration Date | 2021-08-18 |
| Last Update Date | 2023-03-16 |