| NPI | 1033968425 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2100X Nurse Practitioner Acute Care (Licence: CO APN.0999740-NP) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner Adult Health (Licence: CO APN.0999740-NP) |
| 363LG0600X Nurse Practitioner Gerontology (Licence: CO APN.0999740-NP) | |
| Enumeration Date | 2024-05-16 |
| Last Update Date | 2024-05-16 |