| NPI | 1932336344 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: CO APN.0995167-NP) |
| Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: WY 26485.976) |
| 363LG0600X Nurse Practitioner, Gerontology (Licence: CO APN.0995167-NP) | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: WY 26485.0976) | |
| Enumeration Date | 2009-06-12 |
| Last Update Date | 2023-02-17 |