| NPI | 1841841681 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: CO APN.0995057-NP) |
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: CO APN.0995057) |
| Enumeration Date | 2019-09-23 |
| Last Update Date | 2019-10-04 |