| NPI | 1699050286 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: KY 52252) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: KY R3482) |
| Enumeration Date | 2011-10-15 |
| Last Update Date | 2021-03-17 |