NPI | 1669032876 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CO C-APN.0004430-C-NP) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: UT 9024277-3102) |
174400000X Specialist (Licence: CO C-APN.0004430-C-NP) | |
363LF0000X Nurse Practitioner, Family (Licence: UT 9024277-4405) | |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2019-06-19 |
Last Update Date | 2022-10-11 |