| NPI | 1467475616 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CO 44544) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CO DR0044544) |
| Enumeration Date | 2006-07-26 |
| Last Update Date | 2023-10-23 |