| NPI | 1508597436 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: MN 74938) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: MN 32614) |
| Enumeration Date | 2022-06-21 |
| Last Update Date | 2023-07-31 |