| NPI | 1912326752 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: PR 21170) |
| Additional Taxonomies | 207YX0901X Otolaryngology Otology & Neurotology (Licence: PR 21170) |
| 207Y00000X Otolaryngology (Licence: AR E12141) | |
| Enumeration Date | 2014-04-09 |
| Last Update Date | 2020-06-17 |