| NPI | 1811130248 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: AR E-8601) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: MS 25188) |
| Enumeration Date | 2009-04-15 |
| Last Update Date | 2020-11-24 |