| NPI | 1508945593 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CO 50666) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AZ 4353) |
| Enumeration Date | 2006-11-02 |
| Last Update Date | 2024-01-23 |