NPI | 1962596353 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: CO DR 0037400) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: NM 20020393) |
Enumeration Date | 2006-10-03 |
Last Update Date | 2013-12-03 |