| NPI | 1700225257 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: KS 0440749) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TN 54356) |
| Enumeration Date | 2013-06-18 |
| Last Update Date | 2022-11-03 |