| NPI | 1902884182 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: KY 40491) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: AL 18540) |
| Enumeration Date | 2006-01-06 |
| Last Update Date | 2022-07-21 |