| NPI | 1073714564 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: MO 2005036993) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: GA 062018) |
| Enumeration Date | 2007-05-30 |
| Last Update Date | 2021-01-13 |