NPI | 1902244965 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: KS 04-39016) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: KS 9408190) |
Enumeration Date | 2013-06-11 |
Last Update Date | 2016-07-21 |