NPI | 1962036715 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IN 71009892A) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: IN 28222838A) |
Enumeration Date | 2020-03-02 |
Last Update Date | 2020-03-10 |