| NPI | 1366005688 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: NY 330179) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: KS 207Y00000X) |
| Enumeration Date | 2019-04-22 |
| Last Update Date | 2024-06-25 |