| NPI | 1750343299 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CO DR.0059376) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: RI MD6148) |
| Enumeration Date | 2006-04-03 |
| Last Update Date | 2018-10-02 |