| NPI | 1215496526 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CO DR.0064933) |
| Additional Taxonomies | 207QB0002X Family Medicine, Bariatric Medicine (Licence: CO DR.0064933) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2019-03-16 |
| Last Update Date | 2024-05-22 |