| NPI | 1437643905 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X (Licence: MI 4351032337) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301115491) |
| 2085R0001X (Licence: CO DR.0073871) | |
| Enumeration Date | 2018-06-19 |
| Last Update Date | 2024-09-03 |