| NPI | 1669616306 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: CA A134214) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: MN 57456) |
| Enumeration Date | 2009-04-24 |
| Last Update Date | 2020-05-29 |