| NPI | 1730313099 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CO DR.0056030) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: LA MD.203892) |
| Enumeration Date | 2009-05-14 |
| Last Update Date | 2020-01-26 |