| NPI | 1437723913 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CO DR.0073127) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NV SL1724) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: CO DR.0073127) | |
| 208D00000X General Practice (Licence: NV DO3585) | |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: CO DR.0073127) | |
| Enumeration Date | 2021-05-18 |
| Last Update Date | 2025-10-03 |