| NPI | 1821580978 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: KS 04-44775) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: KS 04-44775) |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: MO 2022013166) | |
| 207R00000X Internal Medicine (Licence: MO 2022013166) | |
| Enumeration Date | 2018-06-05 |
| Last Update Date | 2025-09-05 |