| NPI | 1700102449 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: LA 320483) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: GA 074391) |
| 207Y00000X Otolaryngology (Licence: CO DR.0060295) | |
| 207Y00000X Otolaryngology (Licence: GA 74391) | |
| Enumeration Date | 2010-04-19 |
| Last Update Date | 2021-01-20 |