| NPI | 1184039000 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: KS 94-08422) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: KS 04-40162) |
| Enumeration Date | 2014-06-30 |
| Last Update Date | 2023-04-21 |