| NPI | 1477838134 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: OH APRN.CNP.020873) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CO 201728) |
| 363LA2100X Nurse Practitioner, Acute Care (Licence: CO NP-990194) | |
| 364SA2100X Clinical Nurse Specialist, Acute Care (Licence: CO CNS-100011) | |
| Enumeration Date | 2011-10-13 |
| Last Update Date | 2018-02-21 |