| NPI | 1023307170 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: WI 66058) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: MN 61264) |
| Enumeration Date | 2011-03-29 |
| Last Update Date | 2022-09-02 |