| NPI | 1386995496 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2100X Nurse Practitioner Acute Care (Licence: CO APN.0990533-NP) |
| Additional Taxonomies | 363LP0222X Nurse Practitioner Pediatrics, Critical Care (Licence: CO APN.0990533-NP) |
| Enumeration Date | 2012-09-28 |
| Last Update Date | 2020-07-24 |