| NPI | 1346718855 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: CO APN.0994281-NP) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CO APN.0994281.NP) |
| Enumeration Date | 2018-11-02 |
| Last Update Date | 2018-11-02 |