NPI | 1750383394 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208800000X Urology (Licence: CO APN.2805-NP) |
Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: CO 103336) |
Enumeration Date | 2005-08-12 |
Last Update Date | 2025-02-07 |