| NPI | 1396798641 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: MO 2016035818) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: MO 20000152068) |
| 207Y00000X Otolaryngology (Licence: AL 20594) | |
| Enumeration Date | 2006-05-18 |
| Last Update Date | 2022-11-23 |