| NPI | 1982337184 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: KS 04-51133) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4351049947) |
| Enumeration Date | 2022-07-05 |
| Last Update Date | 2025-07-07 |