| NPI | 1609221563 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: SD 12813) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: NE 33769) |
| Enumeration Date | 2016-04-28 |
| Last Update Date | 2021-08-25 |