| NPI | 1902293129 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207YX0007X Otolaryngology, Plastic Surgery within the Head & Neck (Licence: MI 4301501821) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: MI 4301501821) |
| Enumeration Date | 2015-04-26 |
| Last Update Date | 2021-06-15 |