| NPI | 1942261474 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CO DR.0071863) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX V4474) |
| 207R00000X Internal Medicine (Licence: VA 0101239146) | |
| Enumeration Date | 2006-04-02 |
| Last Update Date | 2024-11-05 |