| NPI | 1295393957 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: KS 05-46297) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: KS 94-09886) |
| Enumeration Date | 2019-05-29 |
| Last Update Date | 2023-06-19 |