| NPI | 1013398833 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: OH 35.134739) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: ID M15103) |
| Enumeration Date | 2015-06-17 |
| Last Update Date | 2020-03-13 |