| NPI | 1558517623 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: WA MD60251426) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CO DR.0072499) |
| Enumeration Date | 2008-08-08 |
| Last Update Date | 2024-03-21 |