| NPI | 1326578022 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: MN 71154) |
| Additional Taxonomies | 207YX0901X Otolaryngology, Otology & Neurotology (Licence: MN 71154) |
| 207Y00000X Otolaryngology (Licence: SC MMD.51142LL) | |
| Enumeration Date | 2017-06-14 |
| Last Update Date | 2024-05-17 |