| NPI | 1609099209 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: NC 2009-02042) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: GA 001281) |
| Enumeration Date | 2007-04-11 |
| Last Update Date | 2022-06-28 |