| NPI | 1568519825 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CO DR0056474) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 336-114293) |
| 207R00000X Internal Medicine (Licence: NM MD2015-0232) | |
| Enumeration Date | 2007-01-05 |
| Last Update Date | 2024-02-10 |