| NPI | 1386030666 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: TN 63765) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: MO 2020019945) |
| Enumeration Date | 2015-04-13 |
| Last Update Date | 2021-07-28 |