| NPI | 1124086723 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CO DR.0063273) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MO 105506) |
| 207Q00000X Family Medicine (Licence: MO 105506) | |
| Enumeration Date | 2006-05-03 |
| Last Update Date | 2019-10-29 |