| NPI | 1437310307 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: KS 04-36282) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: MO 2013009427) |
| Enumeration Date | 2008-06-23 |
| Last Update Date | 2025-10-20 |