| NPI | 1326765793 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: CO APN.0998154-NP) |
| Additional Taxonomies | 363LA2100X Nurse Practitioner, Acute Care (Licence: CO APN.0998154-NP) |
| Enumeration Date | 2022-10-26 |
| Last Update Date | 2022-11-03 |