| NPI | 1194067819 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: CO DR.0060621) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: CO 60621) |
| Enumeration Date | 2013-03-20 |
| Last Update Date | 2022-10-26 |