| NPI | 1629050091 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CO DR.0067278) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: CO DR.0067278) |
| 207Q00000X Family Medicine (Licence: IL 036110525) | |
| Enumeration Date | 2005-11-18 |
| Last Update Date | 2023-09-19 |