| NPI | 1740843986 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: KS 05-51224) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: VA 0102207138) |
| 208D00000X General Practice (Licence: VA 0102207138) | |
| Enumeration Date | 2019-04-14 |
| Last Update Date | 2025-06-20 |