| NPI | 1134192248 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: AZ 49389) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: CO 43544) |
| Enumeration Date | 2006-02-09 |
| Last Update Date | 2020-04-29 |