| NPI | 1073716502 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CO DR.0054614) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 248967) |
| 207R00000X Internal Medicine (Licence: CA a125399) | |
| Enumeration Date | 2007-06-11 |
| Last Update Date | 2019-11-19 |