| NPI | 1568308013 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: CO APN.1002146-NP) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CO RN.1655503) |
| Enumeration Date | 2026-04-27 |
| Last Update Date | 2026-07-13 |