| NPI | 1831535962 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CO DR.0056892) |
| Additional Taxonomies | 208D00000X General Practice (Licence: CO DR.0056892) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2013-05-15 |
| Last Update Date | 2024-02-21 |