| NPI | 1972721348 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: KS 0433742) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: KS 946560) |
| Enumeration Date | 2007-04-23 |
| Last Update Date | 2013-01-25 |