| NPI | 1841603792 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: OH 35.142406) |
| Additional Taxonomies | 208600000X Surgery (Licence: MA L-259524) |
| Enumeration Date | 2014-06-09 |
| Last Update Date | 2021-07-19 |