| NPI | 1295122265 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: GA 90653) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: MA 282986) |
| Enumeration Date | 2015-04-17 |
| Last Update Date | 2022-05-17 |