| NPI | 1508326232 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CO dr.0065506) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: CO DR.0065506) |
| Enumeration Date | 2019-03-20 |
| Last Update Date | 2025-06-16 |