| NPI | 1487016069 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: KS 05-41828) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: KS 94-08945) |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: MO 2023025750) | |
| Enumeration Date | 2016-03-23 |
| Last Update Date | 2024-02-08 |