| NPI | 1023076528 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: OK 4987) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: KS 0531167) |
| Enumeration Date | 2006-05-03 |
| Last Update Date | 2020-10-30 |