| NPI | 1992771109 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CO 435415) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CO 43515) |
| Enumeration Date | 2006-02-27 |
| Last Update Date | 2019-05-21 |