| NPI | 1689838385 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CO DR.0070442) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: VA 0102202499) |
| Enumeration Date | 2008-07-11 |
| Last Update Date | 2023-07-18 |