| NPI | 1467483289 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CO DR.0050568) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 219050) |
| Enumeration Date | 2006-07-06 |
| Last Update Date | 2016-08-09 |