| NPI | 1528462975 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CO APN.0991479-NP) |
| Additional Taxonomies | 163WE0003X Registered Nurse, Emergency (Licence: CO 0180603) |
| 363LA2100X Nurse Practitioner, Acute Care (Licence: CO APN.0991479-NP) | |
| Enumeration Date | 2014-10-14 |
| Last Update Date | 2016-04-04 |