| NPI | 1932544533 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: IN 28164023A) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: IN 71004460A) |
| Enumeration Date | 2013-05-08 |
| Last Update Date | 2022-06-21 |