| NPI | 1508187378 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IN 01070114A) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: KS 0448801) |
| Enumeration Date | 2010-06-16 |
| Last Update Date | 2026-08-21 |