| NPI | 1588813240 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 207RN0300X Internal Medicine, Nephrology (Licence: KS 05-33901)  | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: KS 05-33901)  | 
| 207RN0300X Internal Medicine, Nephrology (Licence: MO 2018010825)  | |
| Enumeration Date | 2008-09-17 | 
| Last Update Date | 2024-12-12 |