| NPI | 1154371003 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: AZ 34984) |
| Additional Taxonomies | 2085R0202X Radiology Diagnostic Radiology (Licence: AZ 34984) |
| 2085U0001X Radiology Diagnostic Ultrasound (Licence: AZ 34984) | |
| 207YX0602X Otolaryngology Otolaryngic Allergy (Licence: AZ 34984) | |
| 174400000X Specialist (Licence: AZ 34984) | |
| Enumeration Date | 2006-05-11 |
| Last Update Date | 2024-08-23 |