| NPI | 1639222037 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: SC LLTL 32328) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: MD D0064630) |
| Enumeration Date | 2007-01-19 |
| Last Update Date | 2020-10-13 |