NPI | 1497322408 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: CO APN.0996672-NP) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: CO RN.0130031) |
Enumeration Date | 2021-06-08 |
Last Update Date | 2024-03-28 |