| NPI | 1588766299 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: UT 1779331205) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: MN 72827) |
| Enumeration Date | 2006-09-02 |
| Last Update Date | 2022-12-22 |