| NPI | 1033747126 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: KS 05-50141) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MO 2023013340) |
| Enumeration Date | 2020-04-01 |
| Last Update Date | 2024-12-07 |