| NPI | 1699336164 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CO DR.0069122) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CO TL.0007918) |
| Enumeration Date | 2019-06-25 |
| Last Update Date | 2022-07-20 |