| NPI | 1457332934 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: MN 61429) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: WI 47435) |
| Enumeration Date | 2005-11-10 |
| Last Update Date | 2020-04-15 |