NPI | 1083002372 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: CO APN-0991533-NP) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: CO APN.0991533-NP) |
Enumeration Date | 2015-01-08 |
Last Update Date | 2025-03-13 |