| NPI | 1053392282 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CO DR.0022982) |
| Additional Taxonomies | 207QG0300X Family Medicine, Geriatric Medicine (Licence: CO 22982) |
| Enumeration Date | 2005-11-05 |
| Last Update Date | 2014-06-12 |