| NPI | 1568758175 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CO DR.0054208) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: VA 0116023494) |
| 208M00000X Hospitalist (Licence: CO DR.0054208) | |
| Enumeration Date | 2011-06-22 |
| Last Update Date | 2016-11-23 |