| NPI | 1831396712 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: MN 50781) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: WI 67844) |
| Enumeration Date | 2007-07-02 |
| Last Update Date | 2020-08-12 |