| NPI | 1659766988 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CO DR.0060426) |
| Additional Taxonomies | 207RA0401X Internal Medicine, Addiction Medicine (Licence: CO 61-20005) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2015-04-03 |
| Last Update Date | 2024-05-11 |