NPI | 1063109338 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CO APN.0998363-NP) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: CO APN.0998363-NP) |
Enumeration Date | 2023-04-18 |
Last Update Date | 2023-07-20 |