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 |