| NPI | 1184844169 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CO DR.0062688) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: KS 0431808) |
| Enumeration Date | 2007-05-01 |
| Last Update Date | 2019-07-12 |