| NPI | 1922461136 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CO DR.0070086) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: VA 0101263026) |
| 207R00000X Internal Medicine (Licence: CA A176905) | |
| Enumeration Date | 2016-04-04 |
| Last Update Date | 2023-07-21 |