| NPI | 1871578393 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: MN 36789) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: WI 24496) |
| Enumeration Date | 2005-12-07 |
| Last Update Date | 2021-03-15 |