NPI | 1609801877 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: CO 33381) |
Additional Taxonomies | 208D00000X General Practice (Licence: CO 33381) |
Enumeration Date | 2006-07-12 |
Last Update Date | 2023-08-24 |