| NPI | 1629427752 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: TN 63144) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: SC MMD.39505 LL) |
| Enumeration Date | 2016-06-09 |
| Last Update Date | 2021-06-11 |