| NPI | 1437673787 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CO APN.0993267-NP) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CO RN.1622104) |
| Enumeration Date | 2017-07-28 |
| Last Update Date | 2022-07-21 |