| NPI | 1417572058 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: KS 04-50974) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 036166424) |
| Enumeration Date | 2020-06-09 |
| Last Update Date | 2025-05-29 |