| NPI | 1528676715 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: CO APN.0995689-NP) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: CO APN.0995689-NP) |
| 363LC0200X Nurse Practitioner, Critical Care Medicine (Licence: CO APN.0995689-NP) | |
| 363LG0600X Nurse Practitioner, Gerontology (Licence: CO APN.0995689-NP) | |
| 363L00000X Nurse Practitioner (Licence: CO APN.0995689-NP) | |
| Enumeration Date | 2020-07-14 |
| Last Update Date | 2022-08-12 |