| NPI | 1619985249 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: CO DR.0036189) |
| Additional Taxonomies | 174400000X Specialist (Licence: CO 36189) |
| Enumeration Date | 2006-08-03 |
| Last Update Date | 2023-08-08 |