| NPI | 1679534788 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CO DR.0037786) |
| Additional Taxonomies | 225500000X Specialist/Technologist (Licence: CO 37786) |
| Enumeration Date | 2006-03-29 |
| Last Update Date | 2013-11-13 |