NPI | 1861125205 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CO C-APN.0004332-C-NP) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: WI 235366-30) |
Enumeration Date | 2022-07-04 |
Last Update Date | 2022-08-09 |