| NPI | 1851534960 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: MO 2018032428) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: TN 55586) |
| Enumeration Date | 2009-04-20 |
| Last Update Date | 2022-08-23 |