NPI | 1912612649 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IN 71014380A) |
Additional Taxonomies | 163WG0000X Registered Nurse, General Practice (Licence: IN 28199038A) |
Enumeration Date | 2023-01-17 |
Last Update Date | 2023-11-13 |