| NPI | 1932885506 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IN 71014050A) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IN 28251414A) |
| Enumeration Date | 2023-06-27 |
| Last Update Date | 2023-06-27 |