| NPI | 1134515380 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CO DR.0068612) |
| Additional Taxonomies | 207RA0401X Internal Medicine, Addiction Medicine (Licence: CO DR0068612) |
| 207R00000X Internal Medicine (Licence: MD D82176) | |
| Enumeration Date | 2015-04-14 |
| Last Update Date | 2024-05-13 |