| NPI | 1003810896 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207YX0007X Otolaryngology, Plastic Surgery within the Head & Neck (Licence: KS 23413) |
| Additional Taxonomies | 174400000X Specialist (Licence: KS 23413) |
| Enumeration Date | 2005-06-09 |
| Last Update Date | 2022-01-31 |