| NPI | 1336709237 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: KS 04-48175) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: SC LL82485) |
| 208000000X Pediatrics (Licence: SC LL82485) | |
| Enumeration Date | 2019-06-13 |
| Last Update Date | 2024-03-29 |