| NPI | 1831254002 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: MO 2014001101) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: WI 38108) |
| Enumeration Date | 2006-12-27 |
| Last Update Date | 2021-02-26 |