| NPI | 1861953556 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CO DR.0069069) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: CO DR.0069069) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: CO 0069069) | |
| Enumeration Date | 2019-03-26 |
| Last Update Date | 2023-10-31 |