| NPI | 1831194943 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: KS 04-26347) |
| Additional Taxonomies | 174400000X Specialist (Licence: KS 0426347) |
| 207RI0200X Internal Medicine, Infectious Disease (Licence: MO 110478) | |
| Enumeration Date | 2005-06-15 |
| Last Update Date | 2021-05-10 |