| NPI | 1376999672 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CO DR.0072521) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: HI 22278) |
| 207R00000X Internal Medicine (Licence: CA A170384) | |
| Enumeration Date | 2016-05-05 |
| Last Update Date | 2024-03-29 |