| NPI | 1457543399 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: LA 202772) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: LA PGY.LSUN.OTOLAR) |
| Enumeration Date | 2007-08-14 |
| Last Update Date | 2024-03-05 |