| NPI | 1417319807 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: LA 327892) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: OH 57.028402) |
| Enumeration Date | 2016-03-24 |
| Last Update Date | 2024-03-28 |