| NPI | 1164003208 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: MN 72021) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: MN 31819) |
| Enumeration Date | 2021-04-20 |
| Last Update Date | 2022-08-11 |