| NPI | 1811517709 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: CO DR.0070127) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CO DR.0070127) |
| 207Q00000X Family Medicine (Licence: AZ R77944) | |
| Enumeration Date | 2020-04-21 |
| Last Update Date | 2024-06-14 |