| NPI | 1326179680 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CO 32321) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CO 32321) |
| Enumeration Date | 2007-03-08 |
| Last Update Date | 2021-09-27 |