| NPI | 1427779008 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CO APN.0999624-NP) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL APRN11021768) |
| 363LF0000X Nurse Practitioner, Family (Licence: CO C-APN.0100385-C-NP) | |
| Enumeration Date | 2022-09-12 |
| Last Update Date | 2024-09-17 |