| NPI | 1528752706 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: CO APN.0998799-NP) |
| Additional Taxonomies | 163WC0200X Registered Nurse Critical Care Medicine (Licence: CO RN.1631382) |
| Enumeration Date | 2023-06-08 |
| Last Update Date | 2024-06-09 |