| NPI | 1710273420 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CO DR.0057482) | 
| Additional Taxonomies | 2083C0008X Preventive Medicine, Clinical Informatics Specialist (Licence: SC 83454) | 
| 207Q00000X Family Medicine (Licence: SC 83454) | |
| 2083P0901X Preventive Medicine, Public Health & General Preventive Medicine (Licence: SC 83454) | |
| Enumeration Date | 2011-06-21 | 
| Last Update Date | 2022-07-21 |