| NPI | 1780188185 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CO DR.0068403) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 286001) |
| 207R00000X Internal Medicine (Licence: RI MD17545) | |
| Enumeration Date | 2018-03-20 |
| Last Update Date | 2023-09-25 |