| NPI | 1932551363 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: KS 0445202) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: GA 8738) |
| 207R00000X Internal Medicine (Licence: GA 85411) | |
| Enumeration Date | 2016-07-11 |
| Last Update Date | 2022-11-03 |