| NPI | 1841279940 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CO DR.0050333) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: HI DOS-1087) |
| Enumeration Date | 2006-01-17 |
| Last Update Date | 2017-11-09 |