| NPI | 1093920746 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CO DR.0056364) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA OS013889) |
| Enumeration Date | 2007-05-14 |
| Last Update Date | 2021-01-08 |