| NPI | 1790781573 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: MI 4301049123) |
| Additional Taxonomies | 207YS0012X Otolaryngology Sleep Medicine (Licence: MI 4301049123) |
| Enumeration Date | 2005-06-25 |
| Last Update Date | 2020-10-29 |