| NPI | 1295116010 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: KS 04-44972) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: MO 2021047254) |
| Enumeration Date | 2015-06-17 |
| Last Update Date | 2025-11-03 |