| NPI | 1720394695 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: CO DR.0068997) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: VA 0101250420) |
| Enumeration Date | 2010-08-29 |
| Last Update Date | 2022-07-20 |