| NPI | 1215121504 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: CO DR.0047559) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CO DR.0047559) |
| Enumeration Date | 2007-08-30 |
| Last Update Date | 2025-01-07 |