| NPI | 1245692284 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083P0901X Preventive Medicine Public Health & General Preventive Medicine (Licence: CO DR.0059576) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CO DR.0059576) |
| Enumeration Date | 2016-03-28 |
| Last Update Date | 2025-04-10 |