| NPI | 1811400849 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: CO APN.0993531-NP) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CO APN.0993531-NP) |
| Enumeration Date | 2017-11-13 |
| Last Update Date | 2022-12-21 |