| NPI | 1639600950 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: CO DR.0064405) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CO DR.0064405) |
| 208D00000X General Practice (Licence: KY 52998) | |
| Enumeration Date | 2017-03-27 |
| Last Update Date | 2023-06-12 |