| NPI | 1326210857 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: WV 23770) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: VA 0101263258) |
| 207Y00000X Otolaryngology (Licence: KY 55925) | |
| Enumeration Date | 2008-03-25 |
| Last Update Date | 2022-01-07 |