| NPI | 1033430335 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: AZ 54293) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: OH 57.025704) |
| Enumeration Date | 2010-06-21 |
| Last Update Date | 2023-12-07 |