| NPI | 1972058477 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IN 71006552A) |
| Additional Taxonomies | 367A00000X Advanced Practice Midwife (Licence: IN 09000276A) |
| Enumeration Date | 2016-08-24 |
| Last Update Date | 2023-10-04 |