| NPI | 1568087385 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LC0200X Nurse Practitioner Critical Care Medicine (Licence: CO APN.0995564-NP) |
| Additional Taxonomies | 363LA2100X Nurse Practitioner Acute Care (Licence: CO APN.0995564) |
| Enumeration Date | 2020-06-08 |
| Last Update Date | 2025-08-07 |