| NPI | 1992832976 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CO 990384) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: CO 38809) |
| Enumeration Date | 2007-02-27 |
| Last Update Date | 2021-06-24 |