| NPI | 1225228158 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CO DR.0058824) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OR MD29357) |
| 207R00000X Internal Medicine (Licence: MI 4301107421) | |
| Enumeration Date | 2007-07-26 |
| Last Update Date | 2021-05-10 |