| NPI | 1598822124 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CO DR.0056888) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NM 91347) |
| Enumeration Date | 2007-01-02 |
| Last Update Date | 2024-09-26 |