| NPI | 1083693634 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: KS 04-29832) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: KS 0429832) |
| Enumeration Date | 2006-01-12 |
| Last Update Date | 2024-04-01 |