| NPI | 1144637976 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CO APN.0992839-NP) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CO APN.0992839-NP) |
| Enumeration Date | 2014-07-14 |
| Last Update Date | 2022-10-28 |