| NPI | 1033603717 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: KS 05-50858) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IA R11316) |
| Enumeration Date | 2018-06-18 |
| Last Update Date | 2025-09-04 |