| NPI | 1386714129 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CO DR-45096) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 221996-1) |
| Enumeration Date | 2006-11-09 |
| Last Update Date | 2022-05-25 |