| NPI | 1386828515 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: KS 04-39331) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NC 2008-01953) |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: MO 2013011744) | |
| Enumeration Date | 2007-12-24 |
| Last Update Date | 2022-06-14 |