| NPI | 1447625694 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CO DR.0070115) |
| Additional Taxonomies | 208D00000X General Practice (Licence: CO DR.0070115) |
| Enumeration Date | 2015-12-13 |
| Last Update Date | 2023-02-13 |