| NPI | 1598960338 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: AZ PB3088) |
| Additional Taxonomies | 174400000X Specialist (Licence: KS 0431857) |
| 207R00000X Internal Medicine (Licence: KS 0431857) | |
| Enumeration Date | 2007-06-20 |
| Last Update Date | 2009-11-16 |