| NPI | 1003820259 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: GA 67757) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: SC 16176) |
| Enumeration Date | 2006-07-27 |
| Last Update Date | 2022-01-07 |