| NPI | 1841650090 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CO DR.0062680) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: GA 008585) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2016-03-01 |
| Last Update Date | 2019-06-12 |