| NPI | 1316318447 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CO C-APN.0100952-C-NP) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: AL 1135683) |
| Enumeration Date | 2015-10-15 |
| Last Update Date | 2023-11-30 |