| NPI | 1972567881 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: KS 04-25910) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: MO 109347) |
| Enumeration Date | 2006-04-17 |
| Last Update Date | 2024-07-22 |