| NPI | 1134214851 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: AZ 57919) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: OH 35.065682) |
| Enumeration Date | 2006-10-04 |
| Last Update Date | 2022-03-03 |