NPI | 1245662576 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: CO APN.0993040-NP) |
Additional Taxonomies | 363LA2100X Nurse Practitioner, Acute Care (Licence: CO APN.0993040-NP) |
363LG0600X Nurse Practitioner, Gerontology (Licence: CO APN.0993040-NP) | |
Enumeration Date | 2013-08-09 |
Last Update Date | 2020-07-27 |