| NPI | 1609306802 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: KS 94-09214) |
| Additional Taxonomies | 207RI0200X Internal Medicine, Infectious Disease (Licence: KS 94-09214) |
| Enumeration Date | 2017-06-19 |
| Last Update Date | 2022-07-21 |