| NPI | 1881227973 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: CT 65617) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: ZZ I-39381) |
| Enumeration Date | 2020-02-17 |
| Last Update Date | 2021-01-12 |