| NPI | 1982578753 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: IN 71017215A) |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: IN 71017215B) |
| 163W00000X Registered Nurse (Licence: IN 28226452A) | |
| Enumeration Date | 2025-10-03 |
| Last Update Date | 2025-11-19 |