| NPI | 1518463447 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: WI 83109) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: IA R-11475) |
| Enumeration Date | 2018-03-31 |
| Last Update Date | 2024-08-01 |