| NPI | 1902253636 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: GA 008235) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: TN 62626) |
| Enumeration Date | 2016-05-23 |
| Last Update Date | 2022-06-29 |