| NPI | 1508394230 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CO DR.0070873) |
| Additional Taxonomies | 2083A0300X Preventive Medicine, Addiction Medicine (Licence: CO DR.0070873) |
| 2083A0300X Preventive Medicine, Addiction Medicine (Licence: MA 287668) | |
| 207R00000X Internal Medicine (Licence: MA 287668) | |
| Enumeration Date | 2017-05-25 |
| Last Update Date | 2023-04-21 |