| NPI | 1194395574 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: CO APN.0996634-NP) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CO RN.1617477) |
| 363LG0600X Nurse Practitioner, Gerontology (Licence: CO APN.0996634-NP) | |
| Enumeration Date | 2021-06-29 |
| Last Update Date | 2024-08-28 |