| NPI | 1982434734 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: CO RN.1623823) |
| Additional Taxonomies | 163WA0400X Registered Nurse, Addiction (Substance Use Disorder) (Licence: CO RN.1623823) |
| 163WA2000X Registered Nurse, Administrator (Licence: CO RN.1623823) | |
| Enumeration Date | 2024-08-06 |
| Last Update Date | 2024-08-06 |