| NPI | 1033614458 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: OR MD214601) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: MN 65850) |
| 207Y00000X Otolaryngology (Licence: MN 29286) | |
| Enumeration Date | 2018-03-27 |
| Last Update Date | 2023-12-08 |