| NPI | 1225011554 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CO DR-49443) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301073389) |
| Enumeration Date | 2005-11-21 |
| Last Update Date | 2020-04-29 |