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 |