| NPI | 1295868917 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: KS 04-52930) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: OK 32874) |
| 207Y00000X Otolaryngology (Licence: IA 37162) | |
| 207Y00000X Otolaryngology (Licence: NE 25845) | |
| Enumeration Date | 2007-03-13 |
| Last Update Date | 2026-08-03 |