| NPI | 1861785065 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: KS 0439681) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: MO 2017003572) |
| Enumeration Date | 2011-05-20 |
| Last Update Date | 2017-05-12 |