| NPI | 1831327840 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CO DR.0063333) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MD D75573) |
| 207R00000X Internal Medicine (Licence: NM MD2014-0547) | |
| 207R00000X Internal Medicine (Licence: AZ R71674) | |
| Enumeration Date | 2009-06-29 |
| Last Update Date | 2019-12-16 |