| NPI | 1770573750 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: ID M-7576) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: ID M7576) |
| Enumeration Date | 2005-10-21 |
| Last Update Date | 2021-05-25 |