| NPI | 1154410389 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CO 48443) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301063691) |
| Enumeration Date | 2006-10-12 |
| Last Update Date | 2021-04-27 |