| NPI | 1588191977 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: KS 04-44383) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MO 2022008454) |
| Enumeration Date | 2017-05-16 |
| Last Update Date | 2023-07-25 |