| NPI | 1184691982 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CO DR.0037192) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CO 37192) |
| Enumeration Date | 2006-03-01 |
| Last Update Date | 2018-08-30 |