| NPI | 1093008583 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: CO DR.0059797) |
| Additional Taxonomies | 174400000X Specialist (Licence: CA A131068) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2011-05-17 |
| Last Update Date | 2021-04-09 |