| NPI | 1528429719 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: VA 0101263378) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: MA 291533) |
| Enumeration Date | 2016-03-15 |
| Last Update Date | 2024-04-12 |