| NPI | 1346680758 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: LA 308399) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: MS T-2709) |
| Enumeration Date | 2013-06-29 |
| Last Update Date | 2021-06-04 |