| NPI | 1891756862 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: KS 424434) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: LA MD.15809R) |
| Enumeration Date | 2006-03-30 |
| Last Update Date | 2024-05-01 |