| NPI | 1295063527 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: CO APN.0010127-NP) |
| Additional Taxonomies | 363LA2100X Nurse Practitioner, Acute Care (Licence: CO APN.0010127-NP) |
| 363LF0000X Nurse Practitioner, Family (Licence: CO NP10127) | |
| Enumeration Date | 2009-11-24 |
| Last Update Date | 2024-02-01 |