| NPI | 1750375663 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: KS 26520) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WI 41096) |
| Enumeration Date | 2005-09-07 |
| Last Update Date | 2023-10-13 |