| NPI | 1326426263 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: CT 64391) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: IA R-10205) |
| Enumeration Date | 2015-05-12 |
| Last Update Date | 2021-06-03 |