| NPI | 1154715191 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner Adult Health (Licence: CO APN.0990896-NP) |
| Additional Taxonomies | 363LA2100X Nurse Practitioner Acute Care (Licence: CO APN.0990896-NP) |
| 364SC0200X Clinical Nurse Specialist Critical Care Medicine (Licence: CO APN.0991637-CNS) | |
| Enumeration Date | 2015-03-27 |
| Last Update Date | 2018-10-15 |