| NPI | 1548654817 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CO DR.0060133) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 298565-1) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2015-03-25 |
| Last Update Date | 2023-10-25 |