| NPI | 1194772152 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: KS 0426481) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL ME77468) |
| Enumeration Date | 2006-05-27 |
| Last Update Date | 2020-11-17 |