| NPI | 1598773939 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: TN 68814) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: MI 4301086459) |
| Enumeration Date | 2006-08-03 |
| Last Update Date | 2023-08-09 |