| NPI | 1437590080 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: AR E-12350) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: MN 58217) |
| Enumeration Date | 2013-07-11 |
| Last Update Date | 2022-09-28 |