| NPI | 1427438282 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NE 31748) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: KS 94-08582) |
| Enumeration Date | 2015-06-05 |
| Last Update Date | 2019-06-25 |