| NPI | 1073001335 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CO DR.0077207) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: VA 0101271448) |
| 207R00000X Internal Medicine (Licence: NC 238690) | |
| Enumeration Date | 2018-04-23 |
| Last Update Date | 2026-08-03 |