| NPI | 1992855365 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CO DR.0054616) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MS 20455) |
| Enumeration Date | 2007-01-10 |
| Last Update Date | 2020-12-23 |