| NPI | 1518370469 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: MI 4301118975) |
| Additional Taxonomies | 208600000X Surgery (Licence: MA L-260353) |
| Enumeration Date | 2014-06-09 |
| Last Update Date | 2020-02-25 |