| NPI | 1447287537 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CO 46460) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: ID O-1316) |
| Enumeration Date | 2006-06-26 |
| Last Update Date | 2020-11-30 |