| NPI | 1467405894 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: AZ 20369) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CO DR.0054861) |
| Enumeration Date | 2006-05-18 |
| Last Update Date | 2024-04-12 |