| NPI | 1770307563 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: CO APN.1000313-NP) |
| Additional Taxonomies | 207RA0401X Internal Medicine, Addiction Medicine (Licence: CO APN.1000313-NP) |
| Enumeration Date | 2024-11-08 |
| Last Update Date | 2024-11-08 |