| NPI | 1871855650 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: AR E14186) |
| Additional Taxonomies | 208D00000X General Practice (Licence: NE 27921) |
| Enumeration Date | 2012-06-08 |
| Last Update Date | 2022-07-28 |