| NPI | 1114363942 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QA0401X Family Medicine, Addiction Medicine (Licence: CO DR.0054067) |
| Additional Taxonomies | 207VX0000X Obstetrics & Gynecology, Obstetrics (Licence: CO DR.0054067) |
| 207Q00000X Family Medicine (Licence: CO DR.0054067) | |
| Enumeration Date | 2013-05-20 |
| Last Update Date | 2025-09-23 |