| NPI | 1629043807 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: KS 04-16964) |
| Additional Taxonomies | 174400000X Specialist (Licence: KS 0416964) |
| Enumeration Date | 2006-02-21 |
| Last Update Date | 2021-04-09 |