| NPI | 1043248701 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OK R0083548) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: CO APN0001635CNP) |
| 363LA2100X Nurse Practitioner, Acute Care (Licence: OK 83548) | |
| 363LC0200X Nurse Practitioner, Critical Care Medicine (Licence: OK 83548) | |
| Enumeration Date | 2006-06-29 |
| Last Update Date | 2025-08-25 |