| NPI | 1932889631 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: IN 71014318A) |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: IN 28283511A) |
| Enumeration Date | 2023-07-19 |
| Last Update Date | 2023-09-12 |