| NPI | 1477523843 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CO DR.0054121) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OK 23305) |
| Enumeration Date | 2006-01-26 |
| Last Update Date | 2023-07-05 |