| NPI | 1578796355 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: CO APN.991183-NP) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NM CNP-02455) |
| 363LA2100X Nurse Practitioner, Acute Care (Licence: FL ARNP9217836) | |
| 363LC0200X Nurse Practitioner, Critical Care Medicine (Licence: NM CNP-02455) | |
| 364SG0600X Clinical Nurse Specialist, Gerontology (Licence: CO APN 0991183-NP) | |
| Enumeration Date | 2009-08-27 |
| Last Update Date | 2018-03-17 |