| NPI | 1518385566 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207YX0901X Otolaryngology, Otology & Neurotology (Licence: KY 56685) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: MI 4301119066) |
| Enumeration Date | 2014-04-06 |
| Last Update Date | 2022-06-20 |