| NPI | 1134531494 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: NE 1456) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: MO 2023034282) |
| Enumeration Date | 2014-05-21 |
| Last Update Date | 2023-09-22 |