| NPI | 1225492614 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: MI 4301506790) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: NY 306597-01) |
| Enumeration Date | 2016-04-11 |
| Last Update Date | 2022-08-01 |