NPI | 1659001667 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NH 090872-23) |
Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: CO APN.0997480-NP) |
363LA2100X Nurse Practitioner, Acute Care (Licence: CO APN.0997480-NP) | |
Enumeration Date | 2022-06-13 |
Last Update Date | 2024-01-11 |