| NPI | 1760003040 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CO APN.1000734-NP) |
| Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: CO APN.1000734-NP) |
| 363L00000X Nurse Practitioner (Licence: TX AP145939) | |
| 363LA2100X Nurse Practitioner, Acute Care (Licence: TX AP145939) | |
| Enumeration Date | 2020-04-28 |
| Last Update Date | 2025-10-15 |