| NPI | 1659733277 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: KS 04-48282) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CO 0059923) |
| Enumeration Date | 2016-03-23 |
| Last Update Date | 2024-05-18 |