| NPI | 1730194531 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CO CDR.0001214) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 036-091850) |
| Enumeration Date | 2006-07-30 |
| Last Update Date | 2021-12-06 |