| NPI | 1801884622 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: AR E-2703) |
| Additional Taxonomies | 174400000X Specialist (Licence: AR e2703) |
| Enumeration Date | 2005-10-06 |
| Last Update Date | 2021-09-01 |