| NPI | 1598943730 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: CO APN.0999395-NP) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CO 179976) |
| Enumeration Date | 2008-02-08 |
| Last Update Date | 2023-12-27 |