| NPI | 1144304205 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CO DR.0051177) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NC 95-00963) |
| Enumeration Date | 2006-10-25 |
| Last Update Date | 2022-01-28 |