| NPI | 1184251159 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: OK 45786) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: UT 12404268-1205) |
| Enumeration Date | 2020-03-26 |
| Last Update Date | 2025-06-30 |