| NPI | 1780677831 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: KS 05-27603) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MO 110747) |
| Enumeration Date | 2005-08-24 |
| Last Update Date | 2024-03-22 |