NPI | 1558850883 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CO APN.0993848-NP) |
Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: CO APN.0993848-NP) |
Enumeration Date | 2018-05-02 |
Last Update Date | 2023-04-25 |