| NPI | 1831130392 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: KS 05-42160) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MO 2002015980) |
| 207RI0200X Internal Medicine, Infectious Disease (Licence: KS 05-42160) | |
| Enumeration Date | 2006-06-08 |
| Last Update Date | 2019-07-16 |