| NPI | 1891822896 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: CO 42443) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: AZ 45010) |
| Enumeration Date | 2007-02-27 |
| Last Update Date | 2021-06-14 |