| NPI | 1710651948 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner Adult Health (Licence: CO APN.0996662-NP) |
| Additional Taxonomies | 363LA2100X Nurse Practitioner Acute Care (Licence: CO APN.0996662-NP) |
| Enumeration Date | 2021-08-02 |
| Last Update Date | 2022-03-04 |