| NPI | 1407204233 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: KS 04-49260) |
| Additional Taxonomies | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: MS 37095) |
| 208600000X Surgery (Licence: SC LL39535) | |
| Enumeration Date | 2016-06-02 |
| Last Update Date | 2026-06-19 |