| NPI | 1477998284 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: KS 0442206) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: MO 2019016546) |
| Enumeration Date | 2013-05-07 |
| Last Update Date | 2025-01-09 |