| NPI | 1346504701 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CO DR.0055505) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125060768) |
| Enumeration Date | 2012-06-30 |
| Last Update Date | 2015-08-03 |