| NPI | 1689763104 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: KS 04-34310) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: FL TRN8992) |
| Enumeration Date | 2006-10-12 |
| Last Update Date | 2012-08-28 |