| NPI | 1841723756 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: NC 2024-00590) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: GA 91811) |
| Enumeration Date | 2017-04-07 |
| Last Update Date | 2024-06-20 |