| NPI | 1700636883 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: KS 04-49481) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: MO 2024027231) |
| Enumeration Date | 2024-03-25 |
| Last Update Date | 2024-07-18 |