| NPI | 1609187871 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: KS 04-40838) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: MO 2010018506) |
| Enumeration Date | 2010-06-23 |
| Last Update Date | 2024-07-29 |