| NPI | 1326081332 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163WX0200X Registered Nurse, Oncology (Licence: CO 130955) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: CO RXN,NP 05-015) |
| Enumeration Date | 2006-06-14 |
| Last Update Date | 2007-07-08 |