| NPI | 1457709222 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: NC 2022-02294) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: IA R-10551) |
| Enumeration Date | 2016-06-02 |
| Last Update Date | 2022-08-23 |