| NPI | 1447395512 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: ND 16376) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: MN 16002) |
| Enumeration Date | 2007-02-20 |
| Last Update Date | 2020-11-20 |