| NPI | 1518311752 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: WI 6229-851) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: MO 2021024792) |
| Enumeration Date | 2016-04-13 |
| Last Update Date | 2022-09-07 |