| NPI | 1386106201 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: GA 99942) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: NC 249966) |
| Enumeration Date | 2019-04-01 |
| Last Update Date | 2024-06-15 |