| NPI | 1972591899 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: NV 15683) | 
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: GA 053153) | 
| 207YP0228X Otolaryngology, Pediatric Otolaryngology (Licence: GA 053153) | |
| 207YX0602X Otolaryngology, Otolaryngic Allergy (Licence: GA 053153) | |
| Enumeration Date | 2005-10-13 | 
| Last Update Date | 2023-01-31 |