| NPI | 1811976285 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: SD 8038) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: AR E-5952) |
| 207Y00000X Otolaryngology (Licence: MN 47998) | |
| Enumeration Date | 2006-01-12 |
| Last Update Date | 2022-03-29 |