| NPI | 1730610379 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: TX U5261) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: MO 2022013623) |
| Enumeration Date | 2017-03-24 |
| Last Update Date | 2023-09-25 |