| NPI | 1225695059 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: MN 67972) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: MN 30049) |
| Enumeration Date | 2019-05-28 |
| Last Update Date | 2020-08-26 |