| NPI | 1295929941 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MO 2011027136) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CO DR.0072195) |
| Enumeration Date | 2007-09-05 |
| Last Update Date | 2024-06-14 |