| NPI | 1194869891 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CO DR.0018893) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CO 18893) |
| Enumeration Date | 2007-02-16 |
| Last Update Date | 2020-04-14 |