| NPI | 1457512121 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: CO 51866) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: MO 2008017177) |
| Enumeration Date | 2008-06-24 |
| Last Update Date | 2023-03-07 |