| NPI | 1073631313 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: PA 442497) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: MO 2005018616) |
| Enumeration Date | 2007-03-26 |
| Last Update Date | 2021-07-28 |