| NPI | 1619471034 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 364SP0809X Clinical Nurse Specialist, Psych/Mental Health, Adult (Licence: CO APN.0993725) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: CO APN.0993725) |
| Enumeration Date | 2018-03-20 |
| Last Update Date | 2022-05-13 |