| NPI | 1659341691 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: MI 5101011463) |
| Additional Taxonomies | 174400000X Specialist (Licence: MI 5101011463) |
| Enumeration Date | 2006-01-24 |
| Last Update Date | 2018-07-16 |