| NPI | 1912061599 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: SC 86203) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: MO 2008002421) |
| 207Y00000X Otolaryngology (Licence: KY TP865) | |
| Enumeration Date | 2006-12-20 |
| Last Update Date | 2021-07-16 |