| NPI | 1093236853 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: CO APN.0996445-NP) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CO APN.0996445-NP) |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: CO C-APN.0001980-C-NP) | |
| Enumeration Date | 2017-07-02 |
| Last Update Date | 2024-05-01 |