| NPI | 1134653876 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CO DR.0064625) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CO TL.0006409) |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: CO DR.0064625) | |
| Enumeration Date | 2017-04-19 |
| Last Update Date | 2023-05-17 |