| NPI | 1215752647 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 364S00000X Clinical Nurse Specialist (Licence: CO APN.0999760-CNS) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CO RN.1696738) |
| Enumeration Date | 2024-11-20 |
| Last Update Date | 2024-11-20 |