| 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 |