| NPI | 1255628848 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207YS0123X Otolaryngology, Facial Plastic Surgery (Licence: KS 04-42618) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: MO 2019033208) |
| 207Y00000X Otolaryngology (Licence: OR MD175467) | |
| 207Y00000X Otolaryngology (Licence: KS 04-42618) | |
| 207YS0123X Otolaryngology, Facial Plastic Surgery (Licence: MO 2019033208) | |
| Enumeration Date | 2011-07-01 |
| Last Update Date | 2022-06-05 |