| NPI | 1336376151 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: CO DR.0057929) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: MO 2013037129) |
| Enumeration Date | 2009-06-18 |
| Last Update Date | 2021-05-19 |