| NPI | 1013357292 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: CO DR.0057552) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NC 191614) |
| 207Q00000X Family Medicine (Licence: CO DR.0057552) | |
| Enumeration Date | 2013-07-02 |
| Last Update Date | 2016-09-27 |