| NPI | 1205331329 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: WI 81765-20) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: MN 29121) |
| 207Y00000X Otolaryngology (Licence: MN 65805) | |
| Enumeration Date | 2018-03-29 |
| Last Update Date | 2023-07-18 |