NPI | 1467447896 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CA 95013876) |
Additional Taxonomies | 163WP0000X Registered Nurse, Pain Management (Licence: CO APN.0992720-NP) |
2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: CO APN.0992720-NP) | |
363L00000X Nurse Practitioner (Licence: CO APN.0992720-NP) | |
363LA2200X Nurse Practitioner, Adult Health (Licence: TN APN0000010682) | |
Enumeration Date | 2005-09-12 |
Last Update Date | 2024-03-12 |