| NPI | 1184876039 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 173000000X Legal Medicine (Licence: TX 207YP0228X) | 
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: TX P7873) | 
| Enumeration Date | 2008-10-22 | 
| Last Update Date | 2022-04-20 |