| NPI | 1700913316 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163WR0006X Registered Nurse, Registered Nurse First Assistant (Licence: CO 116923) |
| Additional Taxonomies | 163WM0705X Registered Nurse, Medical-Surgical (Licence: CO 116923) |
| Enumeration Date | 2007-02-28 |
| Last Update Date | 2011-06-10 |