| NPI | 1780655878 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RS0012X Internal Medicine, Sleep Medicine (Licence: CO 38257) |
| Additional Taxonomies | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: CO 38257) |
| 332B00000X Durable Medical Equipment & Medical Supplies | |
| Enumeration Date | 2006-01-28 |
| Last Update Date | 2018-09-17 |