| NPI | 1780629717 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: CA C136123) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: MD D59547) |
| Enumeration Date | 2006-06-16 |
| Last Update Date | 2021-11-05 |