| NPI | 1114946704 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: MI 4301075607) |
| Additional Taxonomies | 174400000X Specialist (Licence: MI 4301075607) |
| Enumeration Date | 2006-07-18 |
| Last Update Date | 2021-02-03 |