| NPI | 1609180157 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: KS 05-37822) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: KS 05-37822) |
| Enumeration Date | 2010-07-27 |
| Last Update Date | 2023-04-21 |