| NPI | 1386106284 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA A187391) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CO DR.0067818) |
| Enumeration Date | 2019-04-01 |
| Last Update Date | 2025-02-06 |