| NPI | 1427017268 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CO DR.0040661) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CO 208011) |
| 208000000X Pediatrics (Licence: CO 77105) | |
| Enumeration Date | 2006-03-21 |
| Last Update Date | 2023-11-09 |