| NPI | 1871939553 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: CO DR.0065201) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: AZ 56006) |
| Enumeration Date | 2013-05-21 |
| Last Update Date | 2022-04-05 |