| NPI | 1811281942 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: NC 2023-01306) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: VA 0101252364) |
| Enumeration Date | 2011-06-07 |
| Last Update Date | 2023-06-14 |