| NPI | 1518223908 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: OH 35.142272) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: GA 078071) |
| Enumeration Date | 2012-04-10 |
| Last Update Date | 2023-04-17 |