| NPI | 1144073487 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: KS 94-11720) |
| Additional Taxonomies | 2085R0001X (Licence: KS 94-11720) |
| Enumeration Date | 2024-04-08 |
| Last Update Date | 2024-06-24 |