| NPI | 1891189478 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CO DR.0060812) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125.066886) |
| Enumeration Date | 2015-03-23 |
| Last Update Date | 2024-05-01 |