| NPI | 1992584270 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: IN 28240808A) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IN 28240808A) |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: IN 71015433A) | |
| Enumeration Date | 2023-09-26 |
| Last Update Date | 2025-01-12 |