| NPI | 1871165217 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CO APN.0996769-NP) |
| Additional Taxonomies | 163WC0200X Registered Nurse, Critical Care Medicine (Licence: CO RN.1633528) |
| Enumeration Date | 2021-07-14 |
| Last Update Date | 2024-02-02 |