| NPI | 1568993509 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: MO 2023012013) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: KY R4574) |
| 207Y00000X Otolaryngology (Licence: MD D94096) | |
| Enumeration Date | 2017-03-22 |
| Last Update Date | 2023-08-30 |