| NPI | 1790353738 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: MO 2023034326) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: MO 2021019861) |
| Enumeration Date | 2021-06-16 |
| Last Update Date | 2023-09-13 |