| NPI | 1861482804 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: CO DR.0030194) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CO 30194) |
| Enumeration Date | 2005-10-21 |
| Last Update Date | 2018-07-09 |