| NPI | 1356007355 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: CO C-APN.0003031-C-NP) |
| Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: CO C-APN.0003031-C-NP) |
| Enumeration Date | 2021-11-14 |
| Last Update Date | 2021-11-14 |