| NPI | 1306136288 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RS0010X Internal Medicine, Sports Medicine (Licence: CO 55360) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CO DR.0055360) |
| Enumeration Date | 2011-04-13 |
| Last Update Date | 2024-06-07 |