| NPI | 1902434814 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CO DR.0071311) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IN 01094457A) |
| Enumeration Date | 2020-03-28 |
| Last Update Date | 2024-08-06 |