| NPI | 1174029078 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: WA MD61425983) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: KY 1174029078) |
| Enumeration Date | 2018-04-01 |
| Last Update Date | 2023-08-23 |