| NPI | 1619121464 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: SC 33458) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: OR 17810) |
| Enumeration Date | 2008-11-06 |
| Last Update Date | 2020-10-22 |