| NPI | 1083243620 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RI0200X Internal Medicine Infectious Disease (Licence: KS 05-50977) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: KS 05-50977) |
| Enumeration Date | 2020-04-06 |
| Last Update Date | 2025-06-19 |