| NPI | 1669086633 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CO APN.0999310-NP) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CO C-APN.0003667-C-NP) |
| 363LF0000X Nurse Practitioner, Family (Licence: IN 28216042A) | |
| 163WE0003X Registered Nurse, Emergency (Licence: IN 28216024A) | |
| 363LF0000X Nurse Practitioner, Family (Licence: IN 71010392A) | |
| Enumeration Date | 2020-09-07 |
| Last Update Date | 2025-02-19 |