| NPI | 1528401676 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: TN 59627) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: MI 4301114127) |
| Enumeration Date | 2013-04-09 |
| Last Update Date | 2024-04-25 |