| NPI | 1760065692 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: MN 71970) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: MN 31640) |
| Enumeration Date | 2021-04-29 |
| Last Update Date | 2022-08-19 |