| NPI | 1912649070 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CO DR.0077858) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: TN 74335) |
| 208M00000X Hospitalist (Licence: CO DR.0077858) | |
| 207R00000X Internal Medicine (Licence: TN 74335) | |
| Enumeration Date | 2022-04-10 |
| Last Update Date | 2026-08-11 |