| NPI | 1275756132 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: KS 432850) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: TN 390200000X) |
| Enumeration Date | 2007-04-10 |
| Last Update Date | 2026-03-18 |