| NPI | 1336567825 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CO DR.0072563) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NM md2016-0912) |
| 207R00000X Internal Medicine (Licence: IA md-44950) | |
| Enumeration Date | 2014-04-01 |
| Last Update Date | 2024-05-07 |