| NPI | 1679990808 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: NH 20647) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: SC 82687) |
| Enumeration Date | 2014-03-26 |
| Last Update Date | 2020-07-21 |