NPI | 1649218389 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: CO DR.0046419) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA 20A9310) |
Enumeration Date | 2006-06-03 |
Last Update Date | 2024-11-07 |