| NPI | 1770847683 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: WI 67254-20) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: MN 56672) |
| Enumeration Date | 2012-06-26 |
| Last Update Date | 2024-02-05 |