| NPI | 1467821009 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: OK 35961) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: CA 138315) |
| Enumeration Date | 2015-09-24 |
| Last Update Date | 2020-07-16 |