| NPI | 1336599679 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: IA 48223) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: MN 68813) |
| Enumeration Date | 2016-06-17 |
| Last Update Date | 2023-08-23 |