| NPI | 1174819817 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CO 053779) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: CO DR.0053779) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: CO TL-3893) | |
| Enumeration Date | 2011-06-21 |
| Last Update Date | 2021-04-29 |