| NPI | 1801886445 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: MN 32055) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: ND 5644) |
| Enumeration Date | 2005-10-25 |
| Last Update Date | 2017-02-16 |