| NPI | 1336180553 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: GA 83729) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: MI 4301081275) |
| Enumeration Date | 2006-06-09 |
| Last Update Date | 2023-01-10 |