| NPI | 1962645366 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: CO DR.0063963) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CO DR.0063963) |
| 207R00000X Internal Medicine (Licence: OH 35.095807) | |
| Enumeration Date | 2009-04-14 |
| Last Update Date | 2023-01-25 |