| NPI | 1245751577 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CO DR.0066561) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125071482) |
| 208000000X Pediatrics (Licence: CO DR.0066561) | |
| Enumeration Date | 2017-06-27 |
| Last Update Date | 2023-10-24 |