NPI | 1285760827 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: CO DR.0066955) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: CO 9923571) |
Enumeration Date | 2007-02-26 |
Last Update Date | 2025-07-09 |