| NPI | 1457039067 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: CO APN.0998863-NP) |
| Additional Taxonomies | 363LA2100X Nurse Practitioner, Acute Care (Licence: CO 0998863) |
| Enumeration Date | 2023-07-05 |
| Last Update Date | 2023-07-31 |