| NPI | 1841804655 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: IN 1831783299) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IN 28251354A) |
| 363LA2100X Nurse Practitioner, Acute Care (Licence: IN 71011450A) | |
| Enumeration Date | 2020-08-31 |
| Last Update Date | 2024-03-06 |