| NPI | 1326283417 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CO DR.0070167) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: UT 7590708-1205) |
| Enumeration Date | 2008-12-03 |
| Last Update Date | 2023-10-24 |